Application Form
Existing Use Certificate
29 Bowler Avenue, Gore 9710
PO Box 8, Gore 9740
Phone 03 209 0330
Email planning@goredc.govt.nz
www.goredc.govt.nz
Application Form Existing Use Certificate
1
I/We (must be the FULL
name(s) of an individual or an entity registered with the New Zealand Companies Office. Where there is a Family
Trust or unofficial trading names, use the trustee(s) and director(s) names instead) hereby apply for an Existing
Use Certificate, pursuant to section 139A of the Resource Management Act 1991.
Site Description
I am/We are the: (owner, occupier, lessee, prospective purchaser etc) of the site
Street Address of Site:
Legal Description:
Certificate of Title Identifier:
Address for Correspondence
Name: (Put your name here if you are preparing the application for someone else.)
Address: Postcode:
Email: Phone (daytime):
Address for Invoices or Refunds (if different from above)
Name:
Address: Postcode:
Bank Details for Refunds
Bank Account Name:
Bank Account Number:
RURAL CITY LIVING
Application Details
Application Form Existing Use Certificate 2
Activity for which Existing Use Certificate Sought
List the rules being breached and describe how the rules breaches will be marginal or temporary:
Current Use Proposed New Use
If a proposed new use is intended, please describe this in detail. For example, describe the type of activity
to be carried out. Discuss the expected bulk and location of buildings, parking provision, traffic movements,
manoeuvring, noise generation, signage, hours of operation, number of people on-site, number of visitors
etc. Please also describe the character, intensity, and scale of the proposed activity.
Please state the current District Plan zoning, any overlays, and state which rules are being breached by the
existing use or will be breached by the proposed new use
Please also state the date upon which the most recent rule requiring resource consent for the use came into
force (state month, year and the relevant rule).
Effects of Use on Date of Most Recent Rule Coming into Force
Please describe in detail the effects of the use of the site when the most recent rule requiring resource
consent for the activity came into force. For example, describe effects relating to the bulk and location of
buildings, parking provision, traffic movements, manoeuvring, noise generation, signage, hours of operation,
number of people on-site, number of visitors etc.
Effects of Activity for Which Existing Use Certificate Sought
Please describe in detail the effects of the activity for which the existing use certificate is sought. For example,
describe effects relating to the bulk and location of buildings, parking provision, traffic movements,
manoeuvring, noise generation, signage, hours of operation, number of people on-site, number of visitors etc.
Application Form Existing Use Certificate 3
Comparison of effects in terms of character, intensity and scale
Compare the effects of the activity on the date the most recent rule requiring resource consent for the activity
came into force with the effects of the activity for which the existing use certificate is sought. Comment on
whether the effects are the same or similar in character, intensity and scale.
Continuity of the Use
Has the current activity been discontinued for a period of more than 12 months? You only need to consider
the period between the most recent rule coming into force and the current date (as long as existing use
rights have been retained between the use first being lawfully established and the date of the most recent
rule coming into force).
Reconstruction, Alteration or Extension to Buildings
Has there been any reconstruction or alteration of, or extension to, any building that increases the degree
to which the building fails to comply with any rule in the District Plan? Consider the period between the
date of the most recent rule coming into force and the current date. Also consider any proposed new
reconstructions, alterations or extensions and whether they will increase the degree of non-compliance
with any rule.
Declaration
I certify that, to the best of my knowledge and belief, the information given in this application is true and correct.
I accept that I have a legal obligation to comply with any conditions imposed on the Resource Consent should
this application be approved.
Subject to my/our rights under section 357B and 358 of the RMA to object to any costs, I agree to pay all
the fees and charges levied by the Gore District Council for processing this application, including a further
account if the cost of processing the application exceeds the deposit paid.
Signature of Applicant/Agent (delete one): Date:
Application Form Existing Use Certificate 4
Application Form Existing Use Certificate 5
Privacy – Local Government Official Information and Meetings Act 1987
You should be aware that this document becomes a public record once submitted. Under the above Act, anyone
can request to see copies of applications lodged with the Council. The Council is obliged to make available
the information requested unless there are grounds under the above Act that justify withholding it. While you
may request that it be withheld, the Council will make a decision following consultation with you. If the Council
decides to withhold an application, or part of it, that decision can be reviewed by the Office of the Ombudsmen.
Please advise if you consider it necessary to withhold your application, or parts of it, from any persons
(including the media) to (tick those that apply):
Avoid unreasonably prejudicing your commercial position
Protect information you have supplied to the Council in confidence
Avoid serious offence to tikanga Maori or disclosing location of waahi tapu
Fees
Council recovers all actual and reasonable costs of processing your application. Most applications require
a deposit and costs above this deposit will be recovered. A current fees schedule is available on
www.goredc.govt.nz or from Planning staff.
Further assistance
Please discuss your proposal with us if you require any further help with preparing your application.
The Council does provide pre-application meetings without charge to assist in understanding the issues
associated with your proposal and completing your application. This service is there to help you.
Please note that we are able to provide you with planning information but we cannot prepare the application
for you. You may need to discuss your application with an expert such as a planning consultant, surveyor or
lawyer, if you need further advice.
Gore District Council Planning Services staff can be contacted as follows:
In Writing: Gore District Council, PO Box 8, Gore 9740
In Person: Gore District Council, 29 Bowler Avenue, Gore,
but please phone first to make an appointment.
By Phone: (03) 209 0330
By Email: planning@goredc.govt.nz
There is also information on our website at www.goredc.govt.nz.
Information requirements (two copies required)
Completed and signed application form
Description of activity
Plan(s) (drawn to scale) showing the height, shape, and location on the site of the activity
Fees
Payment Method
Cash (do not post)
EFTPOS (at Gore District Council)
Cheque
Internet banking
Cheques payable to: Gore District Council
Post cheques to: Gore District Council
PO Box 8, Gore 9740
Internet Banking Payments: Gore District Council
Account Number: 03-0915-0289519-00
Particulars: Please use your Name
Reference: Please use your Address
In order to ensure your application is not rejected or delayed through requests for further information,
please make sure you have included all of the necessary information.
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