SOUTH AUSTRALIAN STRATEGIC COASTAL MANAGEMENT INVESTMENT PLAN 2017 – 2027 PROJECT NOMINATION FORM This form is to be used by Councils to nominate projects for consideration during preparation of a ten-year prioritised coastal management investment plan by the Department of Environment, Water and Natural Resources (DEWNR) in response to the Coast Protection Board Position Paper (2015). The Council contact nominated in Section 1 should have a technical understanding of the projects as they will be contacted by DEWNR for further information during the project assessment and prioritisation process. Section 2 of this form contains “drop-down” menus to simplify the application process. The form is available to download at http://www.environment.sa.gov.au/get-involved/grants-andfunding/Coast_protection_fund_grants or by contacting James Guy on 8124 4907 or james.guy@sa.gov.au Completed forms are to be submitted by email to james.guy@sa.gov.au or by mail to: James Guy, Team Leader Coastal Programmes Department of Environment, Water and Natural Resources GPO Box 1047 ADELAIDE SA 5001 An email confirming receipt of completed forms will be sent to the nominated Council contact. The closing date for submission of Project Nomination Forms is 31 March 2016. Section 1: Council Details 1 Council name and contact person for project enquiries COUNCIL NAME 2 Contact person Phone Position Email Approval by Authorised Representative of Council Signature Name Date Position For use by DEWNR Received Date / / By: Acknowledgement Issued Date / / By: South Australian Strategic Coastal Management Investment Plan 2017 – 2027 Project Nomination Form Section 2: Nominated Project Details Project Type: Choose an item. Council: Project Name: Brief Description: Project Costs Estimate based on: Choose an item. Estimated Cost: Estimate accuracy: Choose an item. Hazard Information Hazard being addressed: Choose an item. Likelihood (if known): Choose an item. Threatened assets: Choose an item. Brief description of threatened assets: Estimated Financial impact of a 1-in-100 year ARI event (if known): Choose an item. Basis of estimated impacts: Choose an item. Timing When is the earliest that the project could Is the project ready to proceed? Yes ☐ No ☐ commence? Choose an item. Are there any prerequisites for the project to proceed? (eg. design study, development application process): Yes ☐ No ☐ If yes, briefly describe: Other Benefits Other than mitigating the hazards described above, briefly summarise any other benefits associated with the project: APPLICATION FOR COAST PROTECTION BOARD GRANT FUNDING IN 2016-17 This process is also being used as the formal invitation for Coast Protection Board grant funding applications for the 2016-17 financial year. Does Council wish this project to be considered for Coast Protection Board grant funding in 2016-17? Yes ☐ Council Contribution (at least 20% of total) No ☐ If yes, complete details below. Other Contribution (amount and source) Requested CPB Grant TOTAL PROJECT COST