Queen Street, P O Box 404, Te Kuiti 3941, NZ. Telephone 07-878 0800, Fax 07-878 7771, Email enquiries@waitomo.govt.nz, Website www.waitomo.govt.nz
Application Form
Entranceway Inspection
This form is to be completed if you are requesting an investigation by Council of a new subdivision or
entranceway.
Upon receipt of this form a site inspection will be programmed. A minimum of 48 hours notice is required.
Name:
Address:
Phone:
Email Address:
Fee Paid:
Applicant’s Signature:
Date:
If applicable, please advise your consultant’s details below:
Consultant:
Address:
Phone:
Email Address:
General nature of request:
Site Plan: (please state address and/or geographical location of works)
Timeframe: 20 days
Roading GL: 740 08265
Sanitation GL: 740 08265
Water GL: 740 08265
Other GL: 740 08265
Date:
Staff Initials:
Date Fee Paid:
Receipt Number:
Section 1 - Applicant Details
Section2-Ofceuseonly
Invoice Applicant
Invoice Consultant
Refer to Fees and Charges www.waitomo.govt.nz
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