Sewerage Infrastructure Drawing Request Form Council of the City of Gold Coast ABN 84 858 548 460 PO Box 5042 GCMC Qld 9729 P 1300 GOLDCOAST E: mail@goldcoast.qld.gov.au W: cityofgoldcoast.com.au Please use BLOCK LETTERS and complete all details in full Privacy statement Council of the City of Gold Coast is collecting your personal information in accordance with the Local Government Act 2009 in order to process the required documentation. This information will only be used by authorised officers to ensure records are accurate. Your information will not be given to any other person or agency unless you have given us permission or we are required or allowed to by law. Requests can be emailed to mail@goldcoast.qld.gov.au or by mail to PO Box 5042 Gold Coast Mail Centre QLD 9729 Allow 10 working days from the date Council has received the request for it to be processed. Contact details Name Postal address Postcode Primary phone Alternative phone Facsimile Email Property details Lot number Registered plan number Property address GTP/BUP/WD Reasons for Request Property Sewer connection point Property settlement Building activity Development Access for CCTV activities Underground drilling or excavating Identification of easements and GCW sewer infrastructure Information Sewerage infrastructure (location, material, size, manhole surface levels, invert levels, ties) and sewer house connection (location, and invert levels). Drawings for sewerage infrastructure are provided to Council by developers and contractors post construction and the information supplied is specific to the requested parcel of land and generally includes the above. Easements over internal infrastructure may not be included on mapping. If the drawing requested is not available, Council may undertake an on-site investigation to confirm the infrastructure and connection locations. All service locations and material type must be confirmed by the applicant on site prior to new design or construction activities. Fees Fee name [√ ] please tick applicable fee(s) Sewerage Infrastructure Drawing Account number Amount 97727 $66.00 A Council officer will contact you via email when the search is available. Payment will then need to be made These fees are in accordance with Councils regulatory fees and non-regulatory charges. A copy of the Councils regulatory fees and nonregulatory charges can be found on the website cityofgoldcoast.com.au Payment options Payment online, by request of City officer via email. Cash, cheque or credit card at any of Councils branch offices. For branch office locations and operating hours, please refer to the City’s website cityofgoldcoast.com.au Cheque or money order by post to Council of the City of Gold Coast PO Box 5042 Gold Coast MC QLD 9729. Please ensure that you provide adequate reference details or attachments to allow the cheque to be appropriately receipted. Please be advised that payments by credit card will incur a surcharge of 0.60% Office use only Document supplied: Dekho Map PDF Drawing Date received Fee paid Received by (name) Receipt number Online payment request date Method of payment PN Number iSpot # #51884257 v1 Last Updated 21/10/2015 Other _________________ Page 1 of 1