Performance bond lodgement – security for rebuilding a removal house Postal Address PO Box 159 Caboolture QLD 4510 Building and Plumbing Ph: 07 3205 0555 Fax: 07 3205 0599 Internet www.moretonbay.qld.gov.au mbrc@moretonbay.qld.gov.au Fees listed are applicable 1 July 2015 – 30 June 2016 ABN: 92 967 232 136 Applicant details: Company name (if applicable): Mr Mrs Ms Miss Given name/s: Surname: Postal address: Email address: Home number: Mobile phone: Work/Business phone: Note: Contact numbers which you provide may be used to update council’s records. Application details: Application number: Site where removal house will be rebuilt: Payment details: Cash bond (bank cheque) Bank guarantee (must not nominate an expiry date) Customer summary: I/We confirm, acknowledge and accept the following: That the minimum bond shall be $45,000.00 (made payable to Moreton Bay Regional Council) That the bond is being paid as security to ensure the removal house is built in accordance with the conditions listed in the concurrence agency response pursuant to the relevant district’s amenity and aesthetics policy for class 1a and class 10a buildings. That the bond may be utilised by council to complete the work in accordance with concurrence agency response and in accordance with the statutory provisions prescribed within the Building Act 1975. That the bond will not be released until a ‘Form 21 – Final inspection certificate’ is issued for the building of the removal house. That the bond will not be released until a Compliance Certificate is issued for the plumbing of the removal house. That a partial release of the bond will only be given when the relevant amount of work has been completed and that an inspection is required to determine if partial release can be given (additional fee will apply). Signature: Date: Office use only Receipt number: _______________ Amount:_________________ Date: ___________________CSO: _____________________ RC TRREM Privacy statement Moreton Bay Regional Council is collecting your personal information for the purpose of processing your bond payment as security for building work to be performed. The collection of this information is authorised under the Sustainable Planning Act 2009. Your information will not be given to any other person or agency unless you have given us permission or we are required by law. Payment options: Payment can be made in person by debit/credit card, cheque/money order or cash at a Customer Service Centre: Caboolture: 2 Hasking Street, Caboolture Strathpine: 220 Gympie Road, Strathpine Redcliffe: Irene Street, Redcliffe Or, please return this form by mail with cheque/money order made payable to Moreton Bay Regional Council. R7 Page 1 of 1 March 16