APPLICATION TO COUNCIL FOR SITING DISPENSATION
TO BUILDING REGULATIONS PART 4 Building Regulations 2006
Attention:
Municipal Building Surveyor
Building Services Department
(Minimum Response Time 2 weeks)
APPLICANT DETAILS
Owner/Agent of Owner* ____________________________________________________________
(*delete as applicable)
Postal Address __________________________________________________________________
____________________________________________________
Contact Person ________________________________
Post Code ____________
Telephone ____________________
Email:___________________________________________________________
OWNERSHIP DETAILS (Only if Agent of Owner listed above)
Full Name(s): __________________________________________________________________
Postal Address _________________________________________________________________
Contact Person ________________________________
Telephone ____________________
RELEVANT BUILDING SURVEYOR
Full Name(s): __________________________________________________________________
Postal Address _________________________________________________________________
Contact Person ________________________________
Telephone ____________________
PROPERTY DETAILS
No. _______ Street/Road ____________________________
Lot No. _______
LP/PS ______________
Suburb ___________________
Volume _________
Folio ________________
Crown Allotment _______ Section_________ Parish County_______________
NATURE OF WORK
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
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CHECKLIST
The following documents are required for this application to be assessed and further information may be requested
depending on the outcome of the below data:

Copy of Title including plan of subdivision and all relevant covenants.



Floor and Site plan – 2 copies - (scale 1:100, 1:200 or 1:500) clearly indicating: -



allotment dimensions, area and north direction

location of any existing building(s) on the allotment and adjoining property building(s)
including roof eave widths, boundary setbacks of buildings, building lengths, window
locations, room usage and boundary fence heights.

distance between the boundary line from the proposed structure and any buildings, including
windows on the adjacent allotments

Drawing elevations – 2 copies - (scale 1:100) clearly indicating all fence heights, wall heights
(measured from natural ground level to the top of roof covering) and all contours of land.



Completed comment forms along with signed copy of plans from the relevant owners of
adjoining properties.


**Adjoining owners of the application have 10 days to respond and advise if they agree
with, or object to, the proposed variation(s).**
* If Comment forms are not provided you must submit one of the following:

A Statutory Declaration detailing your efforts to gather comments including the
timeline of correspondence sent to owner of neighbouring property.

Registered Mail. Mail the comment form along with a copy of the plans to the
adjoining owner. Keep the Registered Mail stub as proof of postage.

A written submission from the applicant detailing the reasons for the request, together with
supporting information (photographs may be included in support of the application)



Applications for consent for overshadowing or overlooking provisions will require overshadowing
and overlooking diagrams illustrated on the site plans and elevations respectively to be
submitted.


NOTE: Failure to supply any items listed above will result your application being returned.

Have the works been completed, if so what percentage of work is completed?_______________
I understand that the applicable fee is non-refundable and that no guarantee can be given that
consent will be granted for the proposed works.
SIGNATURE OF OWNER OR AGENT __________________________________
Date _______________
OFFICE USE ONLY:

HAS THIS APPLICATION BEEN CHECKED BY BUILDING STAFF?
QTY.
DESCRIPTION
PRICE
Dispensation - Dwellings and Outbuildings, Fences & Misc
*Regs. 408 to 431 (AP/BPA/PP)
TOTAL
$244.00
TOTAL AMOUNT PAYABLE
Fees Paid: Yes / No
Receipt No. ……………………
Date Application Received: ……………………
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ONSITE COMMENTS
SUBMISSION FORM
Please provide reasons for this request and supporting information.
Signature of Owner / Agent _____________________________
Date __________
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DWELLINGS AND OUTBUILDINGS - FEE $244.00 per Regulation (cost subject to legislative change)
Please tick the appropriate box and ensure that the information requested on the previous checklist and that mentioned below is illustrated on the
site plan, floor plan and elevations. Further information may be requested dependant on the particular design or affected allotments.

Maximum boundary setback does not comply with Regulation 408
Proposed setback __________

Minimum setback from a street boundary does not comply with Regulation 409
Proposed setback ________

Adjoining property setbacks __________ & __________
Adjoining property setbacks __________ & __________
Maximum building height does not comply with Regulation 410
Proposed building height (measured to the ridge of roof covering). Any adjoining property building heights

Site coverage exceeds 60% of the allotment which does not comply Regulation 411
Existing site coverage __________ Proposed site coverage (including existing) __________

Impermeable surfaces covering more than 80% of an allotment area which does not comply with Regulation 412
Existing impermeable surface area.

Proposed impermeable surface area (including existing area)
The Minimum 2 Car parking space dimensions do not comply with Regulation 413
Existing and proposed car parking dimensions of each car space ______x_______ & _______x________

Side or rear boundary setbacks do not comply with Regulation 414
Existing setback _____

Proposed building setback ____ Proposed wall height (measured from natural ground level to top of roof) _____
Walls within 200mm of a boundary or carports within 1m of boundary, that do not comply with the average height of 3.2m,
maximum height of 3.6m or maximum length allowed by Regulation 415.
 Reg 415(2) - Proposed wall length including the length of any existing wall or carport close to the boundary ______.
 Reg 415(3)(a) - Proposed average wall height, measured from the natural ground level ______.
Reg 415(3)(b) - Proposed maximum wall height , measured from the natural ground level _____.

Wall or carport is within the minimum 1m wide x 3m long light court or exceeds an average height of 3.0m and is within the
minimum light court setback mentioned in Regulation 416(3) from an existing habitable room window in an existing building
on an adjoining allotment (daylight to existing habitable room window). Consent and Report is required in accordance with
Regulation 416(6)
Adjoining building floor level at window(measured from natural ground level) _______
Adjoining building roof boundary setback (measured from the outermost projection)
_______
Proposed wall or carport height (measured from natural ground level and top of roof ) _______
Proposed building roof boundary setback (measured from the outermost projection)

_______
Solar access for a distance of 3m each side of an existing northerly facing habitable room window of an existing building on
an adjoining allotment which is located within 3m of the boundary of the allotment on which the proposed building is to be
constructed. Consent and Report is required in accordance with 417.
Existing adjoining building boundary setback _______ Proposed building boundary setback ________
Proposed building wall or carport height (measured from natural ground level to roof) ________

Overshadowing of the adjoining allotments recreational private open space is less than 75% or 40m2 (with a Minimum
dimension of 3m) whichever is the lesser and does not comply with Regulation 418.
Nominate on the site plan the adjoining allotments recreational private open space which is at the side, rear or front (only where the allotment
is screened for 90% of its perimeter by a 1.5m high fence/structure with no more than 25% of its surface area open) of the existing dwelling.

Overlooking into the adjoining allotments secluded private open space or habitable room, which does not comply with
Regulation 419.
Illustrate on the site plan the outline of the adjoining building, window locations and room usage, and boundary fence heights.
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On the elevation plan please illustrate the boundary fence height and ground contours.


Daylight to new habitable room window of a proposed building does not comply with Reg 420
The private open space of a proposed building is less than 80m2 or 20% of the area of the allotment, whichever is the
lesser, which does not comply with Regulation 421
Proposed private open space area (including dimensions) _____ Existing Private open space _____
MISCELLANEOUS

Siting of a Class 10 building is not the same allotment as a building of another class to which it is
appurtenant, which does not comply with Regulation 422.
FENCES per Regulation
Please tick the appropriate box and ensure that the information requested on the previous checklist and that mentioned below is illustrated on
the site plan, floor plan and elevations. Further information may be requested dependant on the particular design or affected allotments.

Maximum front fence height does not comply with Regulation 424
Existing fence heights of adjoining and nearby allotments within the street that are similar if not greater height
than the proposed fence






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Fence on a side or rear boundary that exceeds 2m in height, which does not comply with the minimum
setback under Regulation 425
Side or rear boundary fence exceeding 2m in height and do not comply with the minimum setbacks or
maximum length required by Regulation 426
A fence within 9m of a point of intersection of street alignments which exceeds 1m in height above the
footpath, which does not comply with Regulation 427.
Daylight to an existing habitable room window from an adjoining allotment does not comply with
Regulation 428
Solar access to existing northerly facing habitable room window of a building from an adjoining allotment
does not comply with Regulation 429.
Overshadowing of the adjoining allotments secluded private open space does not comply with Regulation
430.
Mast, pole, aerial, antenna, chimney flue pipe or other service pipe exceeds a height of 8m above the
ground or 3m above the highest point of the roof (when attached to the building), which does not comply
with Regulation 431.
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ADJOINING OWNERS COMMENT FORM
APPLICATION FOR COUNCIL ‘REPORT AND CONSENT’
Building Regulations 2006
**Adjoining owners of the application have 10 days to respond and advise if they agree
with, or object to, the proposed variation(s).**
I am the owner of the property at ________________________________________________ which
adjoins the property at the following address:
and
I have sighted and signed the attached plans (drawing numbers _________________) for my
neighbours proposed works at:
I am aware that the proposed works are designed outside the siting requirements prescribed in the
Building Regulations 2006 and:
(a)
Do not object to Council issuing consent to the proposed siting of the building/structure pursuant
to Building Regulations Part 4 or,
(b)
Object to Council issuing consent to the proposed siting of the building/structure pursuant to
Building Regulations Part 4.
Please clearly circle the above option that is applicable.
Please provide your reasons if you object to the proposal in order for Council to take into account your
issue(s) for concern.
Please print your name here: _________________________________________________________
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and sign here _______________________ and date here ________________
Note: This comment form and copy of the plans must be signed by the legal owner of the
relevant property within 10 days of receipt. Signatures from persons renting the property
will not be accepted.
For further information please contact Councils’ Building Services Unit on 5320 5650 or in person
at The Phoenix Building, Armstrong St South, Ballarat.
ADJOINING OWNERS COMMENT FORM
APPLICATION FOR COUNCIL ‘REPORT AND CONSENT’
Building Regulations 2006
**Adjoining owners of the application have 10 days to respond and advise if they agree
with, or object to, the proposed variation(s).**
I am the owner of the property at ________________________________________________ which
adjoins the property at the following address:
and
I have sighted and signed the attached plans (drawing numbers _________________) for my
neighbours proposed works at:
I am aware that the proposed works are designed outside the siting requirements prescribed in the
Building Regulations 2006 and:
(a)
Do not object to Council issuing consent to the proposed siting of the building/structure pursuant
to Building Regulations Part 4 or,
(b)
Object to Council issuing consent to the proposed siting of the building/structure pursuant to
Building Regulations Part 4.
Please clearly circle the above option that is applicable.
Please provide your reasons if you object to the proposal in order for Council to take into account your
issue(s) for concern.
Please print your name here: _________________________________________________________
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and sign here _______________________ and date here ________________
Note: This comment form and copy of the plans must be signed by the legal owner of the
relevant property within 10 days of receipt. Signatures from persons renting the property
will not be accepted.
For further information please contact Councils’ Building Services Unit on 5320 5650 or in person
at The Phoenix Building, Armstrong St South, Ballarat.
AGENT AUTHORISATION FORM
Under S248 of the Building Act 1993
I
(Owner/s Name)
Of
(Owner/s Postal Address)
declare that as the owner of the property known as:
(Full address of proposed site for works)
(Description of Work)
authorise for the purpose of this building application
(Full Name of Agent)
of:
(Postal Address of Agent)
to act on my behalf at the above mentioned building or land for the purpose of making any application,
appeal or referral under the Building Act.
This agent authorisation is made pursuant to Section 248 of the Building Act 1993.
Owner/s Signature:
Date:
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