SECTION A - FORMS
APPLICATION KIT FOR SUBDIVISION RESOURCE
CONSENT UNDER SECTION 88 OF THE RESOURCE
MANAGEMENT ACT 1991
PLEASE READ AND COMPLETE
CONTENTS:
5.
Application Form (To be completed)
Page 2
6.
Information Checklist (To be completed)
Page 6
7.
Development Requirements Checklists (To be completed)
Page 10
8.
Design Requirements Checklists
Page 12
9.
Affected party written approval consent form
(To be completed for each affected party as necessary)
Page 16
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APPLICATION FOR RESOURCE CONSENT FOR
A SUBDIVISION
Under Section 88 of the Resource Management Act, 1991
Return completed form, supporting documents and application fee to:
Kapiti Coast District Council,
175 Rimu Road, Paraparaumu 5032
Private Bag 60601, Paraparaumu 5254
For enquiries:
Phone 04 296 4700 or toll free 0800 486 486 and ask for the Duty Planner
Email: resource.consents@kapiticoast.govt.nz
Council use only
Date Lodged:
Formally Received:
Fee Received:
RM Number:
Please provide two copies of all attachments, unless otherwise specified in checklist
PART 1 – Resource Consent
Description of the Activity or Proposed Works
(eg. Construction of a dwelling with a height or yard encroachment)
Type(s) of Resource Consent sought from the Council

Please tick the relevant box(es)
Allotment creation (fee simple) including boundary adjustments
Unit Title
Cross Lease
Company Lease
Landuse
Other resource consent eg. Regional Consent
Please explain below
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Part 2 – Details of the Applicant(s)
I/We apply for the resource consent(s) described above:
Applicant’s name: (please write all names in full)
Agent’s name: (if different from above)
Contact postal address:
Billing address: (if different from above)
Applicant/Agent’s contact details:
Landline:
Mobile:
Email:
Part 3 – Site Information
The physical site to which this application relates is described as:
No:
Street:
Town:
Legal Description:
Part 4 – Supporting Information Required
I/We provide the following information in support of this application to satisfy the requirements of Section 88 (4) of the Resource
Management Act 1991
 Assessment of Environmental Effects. This should be relevant to the scale of the proposal. Refer to
the attached form for further information
 Completed information required under District Plan – Please use and attach a separate sheet. (Refer
checklist provided in the Subdivision Application kit)

Affected parties approval form(s) refer to Subdivision Application Kit

Certificate of Title for the site (Note: to be no more than 3 months old)

Diagrams or plans attached

Easement / encumbrances attached
If you are unsure about any information requirements please contact the Council or your Planning Advisor before you submit your
application. This will help to reduce potential delays in processing.
Subdivision Applications Only
Please attach the following information in accordance with Section 219 of the Resource Management Act:
The position of new boundaries
The areas of all new allotments (not required for cross leases, company leases or unit plans)
The location and areas of new reserves to be created, including any esplanade reserves to be set aside on a
survey plan under Section 230 of the RMA (Resource Management Act)
The location and areas of any esplanade strips to be created under Section 232 of the RMA
The location and areas of any existing esplanade reserves, esplanade strips or access strips
The location and areas of land below mean high water springs of the sea or of any part of the bed of a river or lake
which is to be vested to the Crown or local authority under Section 237 A of the RMA
The location and areas of land to be set aside as new roads
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Application Fee (Deposit)
I/We enclose the fee of $
(refer to fee schedule found in Section B of the kit)
Privacy Information
The information you have provided on this form is required so that your application for consent can be processed under the RMA
1991, and so that statistics can be collected by the Council. The information will be stored on a public register, and held by the
Council.
The details may also be made available to the public on the Council’s website, www.kapiticoast.govt.nz. These details are collected to
inform the general public and community groups about all consents which have been received and issued through the Council. If you
would like to request access to, or correction of, your details please contact the Council on 04 296 4700 or toll free on 0800 486 486
and ask for the Duty Planner.
Once this application is lodged with Council it becomes public information. If there is any sensitive information in the proposal, you
may request that it is withheld and the Processing Officer will contact you regarding this matter.
Signature(s)
I/We hereby certify that, to the best of my/our knowledge and belief, the information given in this application is true and correct. I/We
undertake to pay all actual and reasonable applications costs incurred by the Kāpiti Coast District Council.
Signature of applicant/agent:
Name:
Date:
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APPLICANTS INFORMATION CHECKLIST
Applicant
Date
Proposal
Please indicate in the boxes whether or not you have provided the following information
with your application. Please note that if the information supplied is not adequate the
application will be delayed until the information is supplied and higher processing costs
may be incurred.
APPLICATION FORM AND DETAILS
Yes
1. Application form fully completed, including the names of all owners
of the land other than the applicant
2. A full description of the activity for which consent is sought and its
location
3. An assessment of any actual or potential effects that the activity may
have on the environment. (This including wetlands, significant native
vegetation , land form features, cultural and heritage sites and on
people and communities.)
4. A statement specifying

any other resource consents that are required and;

whether they have been applied for.
SITE INFORMATION
5. The following must be supplied

a legal description of the site

current copies of all certificates of title

an assessment, including diagrams, of the significant views onto
and off the site. (where relevant)
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No
SITE PLANS
Plans must be supplied and drawn to an appropriate metric scale to show sufficient
detail of the proposal to enable Council to determine its effects. If the plans are larger
than A3, copies reduced to A3 must be provided.
6. The site plans must show

a north point accurately oriented

a unique plan number and title describing the proposal

the date, name of the company and locality plan

existing high voltage electricity and high pressure gas
transmission lines
7. A site plan detailing the existing situation including

topographical information, in terms of DOSLI Datum, together
with a certificate to its origin and accuracy

the design of earthworks and final levels and contours of the site

details of hazardous areas (for example uncompacted filing or
flood prone areas or areas subject to earthquake or geological
hazards)

existing buildings and buildings on adjacent sites

landforms and landscape elements

location of watercourses, drainage channels and water table with
comment on their condition, including identification of areas
known to be subject to inundation, subsidence, slippage or
erosion.

the location and areas of any existing esplanade reserves,
esplanade strips or access strips

all vegetation over 3 metres in height, including individual
specimens

existing street names and numbers

existing easements and covenant areas

any existing heritage features (i.e. archaeological or cultural sites
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8. A site plan detailing the proposed subdivision development
including

the position of all proposed lots and certificate of title boundaries

the areas of all new lots

indicative building positions and indicative vehicle access points
and driveways on street edges

location and type of all proposed trees and other vegetation,
including all existing vegetation to be retained

a report from a suitably qualified and experienced person to
demonstrate that:
 a water supply of sufficient quality and quantity can be
provided for the activities proposed for the subdivision and
that there will be no adverse effects on other users or on
natural and physical resources
 the disposal of wastes generated by the activity proposed
for the subdivision will have no adverse effects on ground or
surface water quality , and that there will be no adverse
effects on consumptive water users or on natural and
physical resources

for lots in the Rural Water Collection area to be used for
plantation forestry, information detailing proposed species and
the extent of planted areas together with an assessment of the
impact on long-term water resources

three names of any new road for consideration for approval of
Council

applications for subdivisions fronting State Highway 1 must
submit evidence of consultation with Transit NZ confirming
compliance with Transit NZ’s requirements

the street reserve proposed to be set aside for new road,
including small areas of open public space intended for
recreational purposes, together with drawing sufficient to
describe the plan and three dimensional qualities of typical and
unique or special areas

Formation widths and grades of proposed roads and rights of
way, parking bays, bus stops and speed control devices

Proposed easement and covenant areas

The location and widths of new reserves to be created, including
any esplanade reserves to be set aside on the survey plan under
Section 231
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
The location and areas of esplanade strips proposed to be
created under Section 232 to meet the requirements of the
District Plan

The location and areas of any land below mean high water
springs of the sea, or any part of the bed of a river or lake, which
is required under Section 237A are to be shown on a survey plan
as land to vested to the Crown

Information to show compliance with any other District Plan rule .
For residential subdivision, the applicant may be required to provide an
annotated print from the most recent acceptable aerial photograph.
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DEVELOPMENT REQUIREMENTS CHECKLIST
Please include this checklist with your Resource Consent Application. The checklist includes
requirements from the Council’s Subdivision and Development Principles and Requirements
(SDPR). The alternate short form checklist may be acceptable for small infill developments and
minor land use applications.
or N/A
Item
General
Preliminary consultation with KCDC undertaken.
Applications include commentary on proposed land uses and factors influencing
design.
Regional Council requirements considered, including any Water Permits.
Concept plan or plan showing total development.
Scheme Plan. (Refer Part 2F(i) to (v) of the SDPR).
Flood issues covered. (Refer Part 2C(v) of the SDPR).
Possible Consent conditions for any Section 106 issues proposed.
Information and plan concerning natural ecosystems. (Refer Part 3B(vii) of the SDPR).
Developer’s or Owner’s Representative with appropriate qualifications appointed.
Suitably Qualified Persons agreed with Council.
Geotechnical and Earthworks
Geotechnical reports. (Refer clause 2.3 of NZS 4404).
Extent of earthworks.
Earthworks Management Plan. (Refer paragraph 3 of Part 4 Schedule 2 of the SDPR).
Foundation soils report.
Iwi consulted.
NZ Historic Places Trust Authority where archaeological site present or suspected.
Transportation and Roads
Connectivity and Cycleway, Walkway, and Bridleway indicative network considered.
Road safety audit report or exemption declaration. (Refer Part 3D (iv) of the SDPR).
Traffic management plan. (Refer clause 3.2.4 of NZS4404).
Roads and Rights-of-way meet District Plan and SDPR requirements.
Off street parking requirements met.
Pedestrian access ways legal width no less than 6 metres.
Stormwater
Stormwater information/report. (Refer paragraph 1 of Part 4 Schedule 4 of the SDPR).
Disposal and Quality considerations in accordance with Part 3E of the SDPR.
Wastewater
Council services available and demand effects considered.
On-site waste water disposal report. (Refer to Part 3 F(vi)(c).
Water Supply
Council services available and demand effects considered.
Fire fighting water supply meets NZ Fire Service Code of Practice SNZ PAS 4509:2003
Landscape Design
Landscape concept plan provided.
Reserves
Note any proposals towards reserve contributions (in accordance with Council policies).
Power, Telecommunications, Gas
Utilities confirm able to provide services.
Alternative means proposed and have prior Council approval.
Design Guide Approach
Design guides that have been used are noted and supporting information provided.
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DEVELOPMENT REQUIREMENTS CHECKLIST (Short Form)
Please include this checklist with your Resource Consent Application for small infill type
developments and minor Land Use applications. The checklist includes requirements from the
Council’s Subdivision and Development Principles and Requirements (SDPR), otherwise the full
Development Requirements Checklist shall be used.
or N/A
Item
General
Scheme Plan. (Refer Part 2F(i) to (v) of the SDPR).
Flood issues covered. (Refer Part 2C(v) of the SDPR).
Possible Consent conditions for any Section 106 issues proposed.
Developer’s or Owner’s Representative with appropriate qualifications appointed.
Suitably Qualified Persons agreed with Council.
Geotechnical and Earthworks
Geotechnical reports. (Refer clause 2.3 of NZS 4404).
Extent of earthworks.
Foundation soils report.
Iwi consulted.
NZ Historic Places Trust Authority where archaeological site present or suspected.
Access
Access meet District Plan and SDPR requirements
Off street parking requirements met.
Stormwater
Stormwater information/report. (Refer paragraph 1 of Part 4 Schedule 4 of the
SDPR).
Disposal and Quality considerations in accordance with Part 3E of the SDPR.
Wastewater
Council services available.
On-site waste water disposal report. (Refer to Part 3 F(vi)(c)
Water Supply
Council services available.
Fire fighting water supply meets NZ Fire Service Code of Practice SNZ PAS
4509:2003
Reserves
Note any proposals towards reserves contributions (in accordance with Council
policies).
Power, Telecommunications, Gas
Utilities confirm able to provide services
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DESIGN REQUIREMENTS CHECKLIST
Please include this checklist with your drawings and specifications submitted for approval. The
checklist part summarises the requirements of the Council’s Subdivision and Development
Principles and Requirements (SDPR). The alternate short form checklist may be acceptable for
small scale developments.
or N/A
Item
General
Design certificate submitted in accordance with Schedule 1A of NZS 4404.
Design meets performance criteria. (Refer Part 3B (ix) of the SDPR).
Alternative designs supported by appropriate information. (Refer Clause 1.5.3.2 of
NZS 4404)
Cost benefit or Life cycle costing information provided. (Refer Clause 1.5.3.3 of NZS
4404).
Documents provided as listed in Clause 1.5.1.1 of NZS 4404.
Drawings provided in accordance with Clause 1.5.2 of NZS 4404.
Two copies of drawings, specifications & calculations provided.
Health & Safety requirements included in specifications. Refer Part 3B (v) of the SDPR)
Working in the Road requirements included in specifications. (Refer Part 3B (viii) of
the SDPR).
Geotechnical and Earthworks
Geotechnical report recommendations incorporated in design and specifications.
Requirements of Earthworks Management Plan incorporated in design & specifications.
Landform modified to the least extent practicable. (Refer clause 2.4.1 NZS 4404).
Earthworks Specification forwarded. (If not already approved).
Design & Specifications meet Resource Consent requirements.
Transportation and Roads
Road design is in accordance with performance criteria and design principles, (refer to
Part 3D (ii) and (iii) of the SDPR) and requirements of Part 3 NZS4404
Urban road design is in accordance with Fig 3.1R Schedule 3 Part 4 of the SDPR; or
Specific design submitted with supporting information.
Rural road design is in accordance with Table 3.2 of NZS 4404; or
Specific design submitted with supporting information.
Rights-of-way and multi unit accesses design is in accordance with clauses 3.3.17 and
3.3.18 of NZS 4404.
Cycleways, walkway, and bridleways provided for.
Road safety audit report provided and recommendations incorporated in design.
(Refer to Part 3D (iv) of the SDPR).
Pavement design in accordance with clause 3.3.3 NZS 4404 with min. depth 200mm.
Basecourse specified is TNZ M/4: 2003 Specification for Basecourse Aggregate –
Wellington 1 Greywacke.
Vehicle crossings located and designed in accordance with clause 3.3.19 of NZS 4404.
Footpath construction in accordance with Figure 3.8 of NZS 4404.
Trap sumps detailed (WCC or similar approved).
Roading Specification forwarded. (If not already approved).
Design & Specifications meet Resource Consent requirements.
Stormwater
No increase in run-off up to the 1 in 10 year storm.
Design is in accordance with the principles outlined in Part 3 E(iv) of the SDPR.
Information requirements under clause 4.3.1.2 NZS 4404 provided.
Isohyet guidelines and charts used for peak flow design.
Minimum pipe sizes in accordance with paragraph 6 of Schedule 4 Part 4 of the SDPR.
Minimum cover in accordance with paragraph 7 of Schedule 4 Part 4 of the SDPR.
On-site disposal/re-use used where appropriate.
Stormwater quality issues addressed.
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or N/A
Item
Stormwater Specification forwarded. (If not already approved).
Design & Specifications meet Resource Consent requirements.
Wastewater
Design is in accordance with the principles outlined in Part 3 F(iv) of the SDPR.
Alternative systems in accordance with principles outlined in Part 3 F(vi) of the SDPR.
All lots provided a connection to Council system where available.
Minimum clearances from other services in accordance with clause 5.3.3 of NZS 4404.
Minimum pipe sizes in accordance with clause 5.3.5.3 of NZS 4404.
Minimum grades in accordance with clause 5.3.5.5 of NZS 4404.
Minimum cover in accordance with paragraph 6 of Schedule 5 Part 4 of the SDPR.
Maintenance structure locations, deflections and internal falls in accordance with Part 5
of NZS 4404.
Wastewater Specification forwarded. (If not already approved).
Design & Specifications meet Resource Consent requirements.
Water Supply
Design is in accordance with Part 6 NZS 4404 & Schedule 6 Part 4 of the SDPR.
Fire fighting water supply meets NZ Fire Service Code of Practice SNZ PAS 4509:2003
All lots provided with a connection. Refer paragraph 8 of Schedule 6 Part4 of the
SDPR
Minimum clearances from other services in accordance with clause 6.3.13 of NZS
4404.
Alternative non potable water supplies considered.
On site storage requirements established. (Minimum 25k litres, 50k litres
recommended)
Water supply Specification forwarded. (If not already approved).
Design & Specifications meet Resource Consent requirements.
Landscape Design
Comprehensive Landscape plan covering new roads, reserves and riparian planting.
Complies with Native Planting Guideline or Environmental guidelines for rural living.
Landscape Specification forwarded. (If not already approved).
Design & Specifications meet Resource Consent requirements.
Reserves
Any works as a contribution to reserves detailed.
Pedestrian access ways specific design (minimum legal width of 6 metres).
Fence heights in accordance with paragraphs 1 & 2 of Schedule 8 Part 4 of the SDPR.
Power, Telecommunications, Gas
Service positions meet typical cross section detail or alternatives approved by KCDC.
Working in the Road requirements met.
Standard Construction Drawings
Standard details from Appendix A, NZS 4404 used (unless other KCDC details
specified elsewhere).
Design Guide Approach
Design guides that have been used noted and supporting information provided
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DESIGN REQUIREMENTS CHECKLIST (Short Form)
Please include this checklist with your drawings and specifications submitted for approval for
small scale works or developments. The checklist part summarises the requirements of the
Council’s Subdivision and Development Principles and Requirements (SDPR).
or N/A
Item
General
Design certificate in accordance with Schedule 1A of NZS 4404.
Design meets performance criteria. (Refer Part 3B (ix) of the SDPR).
Alternative designs supported by appropriate information. (Refer Clause 1.5.3.2 of
NZS 4404)
Documents provided as listed in Clause 1.5.1.1 of NZS 4404.
Drawings provided in accordance with Clause 1.5.2 of NZS 4404.
Two copies of drawings, specifications & calculations provided.
Health & Safety requirements met. (Refer Part 3B (v) of the SDPR).
Working in the Road requirements met. (Refer Part 3B (viii) of SDPR).
Geotechnical and Earthworks
Geotechnical report recommendations incorporated in design and specifications.
Landform modified to the least extent practicable. (Refer clause 2.4.1 NZS 4404).
Design & Specifications meet Resource Consent requirements.
Access
Access design is in accordance with clauses 3.3.17 and 3.3.18 of NZS 4404.
Vehicle crossings located and designed in accordance with clause 3.3.19 of NZS 4404.
Trap sumps detailed (WCC or similar approved).
Design & Specifications meet Resource Consent requirements.
Stormwater
Minimum pipe sizes in accordance with paragraph 6 of Schedule 4 Part 4 of the SDPR.
Minimum cover in accordance with paragraph 7 of Schedule 4 Part 4 of the SDPR.
On-site disposal/re-use used where appropriate.
Design & Specifications meet Resource Consent requirements.
Wastewater
All lots provided a connection to Council system where available.
Minimum clearances from other services in accordance with clause 5.3.3 of NZS 4404.
Minimum pipe sizes in accordance with clause 5.3.5.3 of NZS 4404.
Minimum grades in accordance with clause 5.3.5.5 of NZS 4404.
Minimum cover in accordance with paragraph 6 of Schedule 5 Part 4 of the SDPR.
Maintenance structure locations, deflections and internal falls in accordance with Part 5
of NZS 4404.
Design & Specifications meet Resource Consent requirements.
Water Supply
Fire fighting water supply meets NZ Fire Service Code of Practice SNZ PAS 4509:2003
All lots provided with a connection. Refer paragraph 8 of Schedule 6 Part 4 of the
SDPR
Minimum clearances from other services in accordance with clause 6.3.13 of NZS
4404.
On site storage requirements established. (Minimum 25k litres, 50k litres
recommended)
Design & Specifications meet Resource Consent requirements.
Landscape Design
Design & Specifications meet Resource Consent requirements.
Power, Telecommunications, Gas
Service positions meet typical cross section detail or alternatives approved by KCDC.
Working in the Road requirements met.
Standard Construction Drawings
Standard details from Appendix A, NZS 4404 used (unless otherwise specified).
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Resource Management Act 1991
NOTICE OF WRITTEN APPROVAL
Consent Application Number (if known): RM
PLEASE READ THE EXPLANATORY NOTES BEFORE COMPLETING AND SIGNING THIS FORM
APPLICATION AND APPLICANT’S DETAILS TO BE COMPLETED BY THE APPLICANT
Applicant(s) Name:
Address and legal description of property to which the application relates:
Full Description* of the proposed activity:
*IMPORTANT NOTE TO APPLICANTS: It is very important that a full and accurate description of the activity is stated. If
this description does not cover all aspects of the proposal the Council may require you to amend this form and re -obtain
all the approvals. Please also ensure that a copy of any plans accompanying the application is signed by all persons
who sign this form. Please seek advice from a Council Resource Consents Planner if you are unsure whether this part
of the form has been filled in correctly.
AFFECTED PERSON’S DETAILS TO BE COMPLETED BY THE PERSON GIVING APPROVAL
PLEASE READ THIS IMPORTANT NOTE BEFORE YOU COMPLETE AND SIGN THIS FORM: You should only sign
this form if you support or have no opposition to the granting of the resource consent for the application referred to
above. If you do not understand any part of this process please seek professional assistance from an independent
source or Resource Consents Planner at the Kapiti Coast District Council as signing this form will prevent Council from
having regard to any effects of the activity on you.
PLEASE COMPLETE EITHER QUESTION 1 OR 2 (AND ANSWER QUESTION 3 IF YOU ARE SIGNING THIS FORM
ON BEHALF OF ANOTHER PERSON)
1.
I have an interest in the property situated at
[insert
physical
address
or
legal
description]
My interest in the above property is as follows (please tick either box (A) or (B)):
A)
I am the owner – (Note: Owner includes all trustees of any trust owning a property and all members
of any Body Corporate authorised to manage a property. It will include all members of any partnership
or syndicate owning the property. It will also include any person(s) or entity that has entered into an
agreement to purchase or lease the property.)
AND (please tick one of the following boxes):
I reside at the property stated above; OR
I do not reside at the property stated above
Please list the full names and contact details of all other registered owners –
OR
B)
I am an occupier
Please list the full names of all other persons over 18 years of age who live at the property –
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2.
I do not own or occupy property near the application site but:
I am (or may be) adversely affected by the proposed activity
Name:
Organisation* (if any):
*For instance: Iwi authority; Department of Conservation; Fish & Game; Historic Places Trust etc…
I have authority to sign this form on behalf of another person(s) –
3.
(i)
(ii)
Please list the full name(s) of any person(s) you are signing on behalf of; and
Provide signed written proof from each person you are signing on behalf of that you have authority to
sign this form on their behalf (note: If you are signing as a person’s attorney, a copy of the Power of
Attorney signed by that person must be provided).
EXPLANATORY NOTES
Written Approval of Person(s) Affected by an Application for Resource Consent Under the Resource
Management Act 1991
What is a Resource Consent?
When people wish to undertake an activity (e.g. build a house) in a way that does not comply with the
‘permitted activity Rules and Standards of the Kapiti Coast District Plan, they require special permission from
the Council to do so. This is known as a “Resource Consent”. If they obtain a resource consent they are able
to undertake the activity in accordance with that consent and its conditions. This process is set down in the
Resource Management Act 1991. An application for Resource Consent can be processed by the Council in
one of two ways. Applications are either notified (public or limited involvement by other people) or non-notified
(that may or may not involve neighbours or other people).
Why is your written approval being sought by the applicant?
If an application for a resource consent is to be processed as a non-notified application, the Resource
Management Act 1991 requires that the proposed activity must have adverse effects on the environment that
are no more than minor AND that written approval must be obtained from every person whom the Council
considers may be adversely affected by the activity. It is the responsibility of the applicant to consult with
persons identified as being adversely affected by the proposal. If you have been asked to give your written
approval it is likely that this is because the Applicant or Council considers that you may be adversely affected
by the proposed activity. This gives you the opportunity to consider the proposed activity and decide for
yourself whether you are adversely affected and/or the degree to which you may be adversely affected.
What should you do if you are asked to sign this form?
If you are asked to give your written approval to someone’s proposed activity as part of their application for a
resource consent, you should do the following:
1. Request that the applicant (or their representative) explain the proposal clearly and fully to you.
2. Study the application and associated plans (if any) provided by them in order to understand the effects of
the proposed activity. If there are no plans available at this stage, you may wish to wait until they are
available. Ask for time to consider the documents if you think you need it.
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3. Decide whether the proposed activity will adversely affect you or your property. You are entitled to ask the
applicant for more information but you should make a decision about whether you will sign the form or not
as promptly as is reasonable under the circumstances. You may suggest amendments to the proposed
activity that you consider would reduce the effects on you. If the proposal is amended by the applicant
then you should only sign the amended version of the proposal. Written approvals will usually be
submitted to the Council by the applicant as part of their application. In other cases the Council may
direct an applicant to obtain certain written approvals after the application has been lodged.
4. If you are satisfied that the proposed activity will not adversely affect you and/or the effects are
acceptable to you, you may decide to sign the affected person’s approval form on the reverse side of this
page and a copy of the application and plans that may accompany the application. You should then
return the completed and signed form (and application and plans) to the applicant (or their
representative). If you are willing to give your approval subject to some other condition being met, this will
need to be the subject of a separate side agreement between yourself and the applicant. The Council will
not accept “conditional approvals”. If you change your mind after signing this form, you may withdraw
your approval at any time before the decision is made on the application by advising the Council in writing
that your approval is withdrawn.
5. If you consider that you will be adversely affected by the proposal and do not wish to sign the approval
form, you will need to advise the applicant (or their representative).
Please note that if a property is owned by more than one person, all of the joint owners are considered to be
“affected persons”. If a property is leased or rented then the Council may deem both owners and occupiers
as affected persons.
Important Information
If you do not give your approval and you are considered by the Council to be an adversely affected person,
then the application must be notified and you will have a formal right to lodge a submission objecting to the
application. Alternatively, the applicant may proceed without the need for a resource consent if they amend
their proposal so that it complies with the relevant permitted activity rules and standards in the District Plan,
or if they amend their proposal so that it still needs a resource consent but the Council no longer considers
that the proposal will adversely affect you.
Please note that the final decision on who is adversely affected or whether the application requires
notification is made by Council staff or contractors qualified and delegated to make these decisions. Even
though you may sign the affected person’s approval form, the Council must give full consideration to the
application in terms of the Resource Management Act 1991. However, if you give your approval to the
application, the Council is not able to have regard to any actual or potential effects the proposed activity may
have on you. If a resource consent is granted by the Council, there is no way for either you or the Council to
retract it later. You are therefore advised to weigh up all effects of the proposed activity before agreeing to it.
If you have any queries regarding the resource consent process or the role and rights of adversely
affected person(s), please contact a Resource Consents Planner at Kapiti Coast District Council or
seek advice from a private planning consultant or legal adviser.
Note that Council staff are not in a position to advise you whether you should sign the form.
Ultimately the decision to sign is your responsibility.
PLEASE TURN PAGE FOR DECLARATION OF WRITTEN APPROVAL
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PAGE INTENTIONALLY BLANK
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WRITTEN APPROVAL
DECLARATION
A. I have read and understood the information provided with this form.
B. I have been given details of the full and final proposal, including a copy of the resource consent
application form, the assessment of environmental effects and any plans accompanying the
application.
C. I give my approval to the proposal as outlined in the resource consent application, the
assessment of environmental effects and any plans.
D. I have signed a copy of the accompanying plans as shown to me by the Applicant for that
purpose.
E. I understand that the Council will not take into account any effects the proposed activity may
have on me when considering the application unless notice is given to the Council by me in
writing prior to the consent being issued that my approval is withdrawn.
Signature:
Print Full Name:
Organisation/Position:
Date:
Daytime Phone Number:
Signature:
Print Full Name:
Organisation/Position:
Date:
Daytime Phone Number:
Signature:
Print Full Name:
Organisation/Position:
Date:
Daytime Phone Number:
Signature:
Print Full Name:
Organisation/Position:
Date:
Daytime Phone Number:
PLEASE USE A SEPARATE SHEET IF MORE THAN FOUR SIGNATORIES & ATTACH TO THIS FORM
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