Statement of Compliance
for Vehicular Access and/or
Drainage Access
Request Form
Document Code:
Version:
Approved Date:
FO-WS-T-003
Burnie City Council
1.0
PO Box 973, Burnie TAS 7320
P 03 6430 5700  F 03 6431 3896
E burnie@burnie.net
6 October 2014
STATEMENT OF COMPLIANCE
FOR VEHICULAR ACCESS and/or DRAINAGE ACCESS
REQUEST FORM
Local Government (Highways) Act 1982 and Urban Drainage Act 2013
Purpose of the Statement of Compliance for Vehicular and Drainage Access
The Burnie Interim Planning Scheme 2013 requires that a planning permit application must establish the suitability of a site for
development by demonstrating that vehicular access is available between the carriageway of a road and the development site in
accordance with the Local Government (Highways) Act 1982. Similarly, the applicant must be able to demonstrate that stormwater from
the development site can drain to a stormwater system in accordance with the Urban Drainage Act 2013.
The Statement of Compliance is an advice from the relevant Road Authority and/or Drainage Authority that access to the respective road
network and stormwater system exists, is achievable and/or may be conditional.
This Statement of Compliance must be included with a planning permit application.
Site of Proposed Development
Street Address
Certificate of Title
Reference
Applicant
Company
Contact Name
Postal Address
Phone No.
Mobile No.
Email Address
Privacy Statement
1. Council is committed to upholding your right to privacy. 2. Personal information collected by Burnie City Council is used in the provision
of services. 3. Information collected will be retained confidentially and disposed of in accordance with requirements of the Personal
Information Protection Act 2004. 4. You have the right to access your own personal information on request.
Print Date: 8/02/16
This document is uncontrolled if printed.
Page 1 of 4
Statement of Compliance
for Vehicular Access and/or
Drainage Access
Request Form
Document Code:
Version:
Approved Date:
FO-WS-T-003
Burnie City Council
1.0
PO Box 973, Burnie TAS 7320
P 03 6430 5700  F 03 6431 3896
E burnie@burnie.net
30 September 2014
Proposed Development
Use Class (In accordance with Burnie Interim Planning Scheme 2013 Clause 8.2)
Brief description of the proposed development in terms of its requirements for vehicular and drainage access.
Access Requirements
(If insufficient space, please attach separate document)
Vehicular Access:
YES
NO
Does the proposed development utilise an Existing Vehicular Access?
☐
☐
If Yes, does the proposed development intensify or change the use of the access?
☐
☐
Does the proposed development require a New Vehicular Access?
☐
☐
Does the proposed development require relocation of an Existing Vehicular Access?
☐
☐
Does the proposed development require modification of an Existing Vehicular Access?
☐
☐
Stormwater Drainage Access:
YES
NO
Does the proposed development utilise an Existing Stormwater Connection?
☐
☐
If Yes, does the proposed development intensify or change the use of the connection?
☐
☐
Does the proposed development require a New Stormwater Connection?
☐
☐
Does the proposed development require relocation of an Existing Stormwater Connection?
☐
☐
Does the proposed development require modification of an Existing Stormwater Connection?
☐
☐
Documents included with the application to describe the vehicular access requirements:
Documents included with the application to describe the drainage access requirements:
Print Date: 8/02/16
This document is uncontrolled if printed.
Page 2 of 4
Statement of Compliance
for Vehicular Access and/or
Drainage Access
Request Form
Document Code:
Version:
Approved Date:
FO-WS-T-003
Burnie City Council
1.0
PO Box 973, Burnie TAS 7320
P 03 6430 5700  F 03 6431 3896
E burnie@burnie.net
30 September 2014
Applicant Declaration
I, ........................................................................................................................................................ (Print Name)
declare that the information I have given in this application to be true and correct to the best of my knowledge.
Signature of Applicant: ................................................................................ Date: .....................................................
Office Use Only
Vehicular access can be / cannot be provided.
Drainage access can be / cannot be provided.
Comments/Requirements:
Endorsed by Council Officer: ....................................................................... Date: .....................................................
This endorsed Statement of Compliance for Vehicular Access and/or Drainage Access Request Form must be included with the planning permit application.
Print Date: 8/02/16
This document is uncontrolled if printed.
Page 3 of 4
Statement of Compliance
for Vehicular Access and/or
Drainage Access
Request Form
Document Code:
Version:
Approved Date:
FO-WS-T-003
Burnie City Council
1.0
PO Box 973, Burnie TAS 7320
P 03 6430 5700  F 03 6431 3896
E burnie@burnie.net
30 September 2014
Instructions for Requesting a Statement of Compliance
a)
Nature of Proposed Development
The application must provide a description of the proposed development and of the manner in which the development
is to operate. This description must provide sufficient detail of the proposed use of the site to allow an assessment of
the requirements for access to the site and/or the requirements to drain stormwater from the site.
Relevant information could include number and type of dwellings proposed, nature of commercial activities including
such factors as frequency, duration, hours of operation, number of possible occupants and customers, extent of
subdivision or the type, frequency and number of vehicles likely to use the site.
Clause 8.2 Burnie Interim Planning Scheme 2013 provides the use classes by which all use or development must be
described. The proposed development must be categorised by reference to the use class it is to serve.
b)
Required Information – Vehicular Access and/or Drainage Access
Adequate statements, diagrams or plans must be included within the application to clearly illustrate the location of the
desired vehicular access and/or drainage access to the site of the proposed development. Diagrams or plans must be to
scale, based on aerial photographs or otherwise allow an accurate position for proposed vehicular access and/or
drainage connection point to be established.
If the application is for a relocation or modification of an existing access, the location of both the existing and proposed
accesses must be clearly shown.
The application must clearly identify the documents relied upon for determination.
c)
Applicant Declaration
The applicant is required to complete a declaration that the information given in this application is true and correct.
General Conditions of Statement of Compliance
a)
The Statement of Compliance is not an approval to create an access, it is merely a statement of whether access can be
provided or not.
b)
If approved, access must be constructed to the approval of the Road Authority and/or Drainage Authority.
c)
This Statement of Compliance is subject to any conditions applied at time of approval.
d)
This Statement of Compliance is valid for a period of 12 months from date of approval.
Print Date: 8/02/16
This document is uncontrolled if printed.
Page 4 of 4