Infrastructure Services
Nillumbik Shire Council
PO Box 476 or Civic Drive
GREENSBOROUGH VIC 3088
Phone: 9433 3111 Fax: 9433 3777
Application for Infrastructure Information
Information Fee $62.60 – GST exempt (effective as of 1 July 2015)
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Drainage Location
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Stormwater discharge point
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Site Specific Information
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Contours
Easements
Other
Complete below and submit to Council with $62.60 fee.
Name of Applicant:
Address:
Email Address:
Phone No.
(H)
(B)
(M)
Subject Address:
Proposed Development:
Other Information:
Signed:
Date:
The personal information requested in this form is being collected by Council for the assessment of building dispensations. This
information will be used solely by Council for those primary, or directly related, purposes. The applicant understands that the personal
information provided is for the assessment of building dispensations and that they may apply to Council for access and /or
amendments of the information.
Revised: July 2015