Advertising device licence/permit
Council of the City of Gold Coast
ABN 84 858 548 460
PO Box 5042 GCMC QLD 9729
P 07 5667 5987
F 07 5596 3653
E mail@cityofgoldcoast.com.au
W cityofgoldcoast.com.au
Licence / permit application
Local Law No. 7 (Council Property) 2008
Local Law No. 9 (Parks and Reserves) 2008
Local Law No. 10 (Bathing Reserves) 2004
Local Law No. 11 (Roads and Malls) 2008
Local Law No. 16 (Licensing) 2008
Please use BLOCK LETTERS and complete all details in full.
This application is for a licence or permit under a Local Law. It does not alleviate the applicant’s responsibility
to complete any other relevant development application forms, for example, Building Act 1975
Section 1 - Applicant
(must be a legal entity e.g. person/s or corporation)
Mr
Applicant/s
name
Mrs
Ms
Miss
ACN
Trading name
Registered
address
Postal address
Contact person
Phone
Mobile
Email
Section 2 – Advertising device location
Real property description
Lot number
Plan
Street address
Premises name
Section 3 – Advertising device details
Face length
Face height
Number of faces
Overall height from ground
2
2
Area per face (m )
Material
Total area all faces (m )
Timber
Metal
other
Device type (e.g.
freestanding, wall
Advertising
content (wording)
Form ADV01 Advertisement Licence 4/2/2016 # 49359422v7
Page 1 of 3
Section 4 - Illumination details
Illuminated
Yes
Type
Internal
No
If yes, please provide type and specifications (eg LED, Neon)
External
Animated
Section 5 – Location and advertising device plan
Please attach detailed plans and/or images which clearly identifies the location of the device on the premises, an
elevation plan and the advertising content.
Advertising devices must achieve the following outcomes
•
ensure that the operation of an advertising device does not create, or increase, a risk to human health or
safety, road safety or the safety of pedestrians; and
•
is appropriately integrated into the built environment and does not create or exacerbate visual clutter; and
•
is complementary to and integrated with the design of a building to which it is fixed; and
•
presents a visually attractive appearance in the context of the desirable characteristics of the natural and
built environment, including public places and the local streetscape; and
•
minimises the impact of the advertising device on access to views and sunlight for residents on adjoining
premises; and
•
does not create or exacerbate a nuisance, for example, a nuisance caused by illumination; and
•
ensuring that advertising devices are safely secured and do not pose a hazard to motorists, pedestrians,
cyclists or residents of adjoining premises; and
•
ensuring that advertising devices are displayed and maintained to essential standards of public safety; and
•
ensuring that the primary purpose of the display of an advertising device on premises is to advertise or
promote 1 or more of the businesses operated on the premises.
Form ADV01 Advertisement Licence 1/102015 # 49359422v6
Page 2 of 3
Section 6 – Landowners details and consent (if different from the applicant)
I give my consent for this application and the activity subject to this application to be carried out on my land and I
understand and acknowledge that:
•
Documentation must be provided for a power of attorney (POA) signing on behalf of a person
•
A person signing on behalf of a corporation or incorporated association must occupy a position that is
legally entitled to make an application on behalf of that corporation or incorporated association
Mr
Mrs
Ms
Miss
Name
Postal address
Contact number
Signature of
landowner
Signature of
authorised agent
Section 7 - Applicant declaration
Date
Date
(must be completed by OR for each applicant)
I understand and acknowledge that:
•
•
•
•
•
•
I will be the licensee and legally responsible for complying with the conditions of approval
I will receive the annual licence renewal
It is an offence to knowingly provide false or misleading information
Approval of this application does not extend to the approval of any other statutory or local government
requirements relating to this premises or activity
Documentation must be provided if a power of attorney (POA) signs on behalf of a person
A person signing on behalf of a corporation or incorporated association must occupy a position that is
legally entitled to make an application on behalf of that corporation or incorporated association
Applicant one
(a person or organisation)
Name
Signature
Complete when signing on behalf of person or
organisation
Signatory name
Date
Position (eg. CEO)
Additional applicant – if required
Name
Signature
Complete when signing on behalf of person or
organisation
Signatory name
Date
Position (eg. CEO)
Privacy statement
Council of the City of Gold Coast is collecting your personal information in accordance with Local Government Act 2009 in order to assess
your application. The information will only be used by authorised officers for the purpose of administering licenses and approvals within the
City. 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. Should approval be given to this application, such approval will not extend to approving any other statutory or Local Government
requirements relating to the property.
Office use only
Date received
Received By
AMS
LI ADV account number
Form ADV01 – Advertisement Licence 4/2/2016 #49359422v7
Page 3 of 3