Fillable Application for Approval of Food Premises Fit-out Plan (New South Wales)

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Application for Approval of Food Premises Fit-out Plan (New South Wales)

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The Application for Approval of Food Premises Fit-out Plan (New South Wales) form is 2 pages long and contains:

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  • 25 check-boxes
  • 32 other fields

Country of origin: AUSTRALIA
File type: PDF

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FoodPremisesFitout.docx / Building and Environmental Health/ Nov-21 Page 1 of 2
Customer Service | 1300 292 872 | (02) 6670 2400
P
O Box 816 Murwillumbah NSW 2484
ABN 90 178 732 496 | tsc@tweed.nsw.gov.au | www.tweed.nsw.gov.au
Application for Approval of Food Premises Fit-out Plan
A1. Application Details
Surname/s
Given
Name/s
OR
Company/
Organisation
ABN
Applicants
Address
Postal
Address
Contact No. Email
Driver Licence No State of Issue
A2. Business Details
New Business
Existing Business
Business Trading Name
Business Site
Address
Business Type
Bakery Supermarket Newsagency Licensed Club
Cake Shop Green Grocer Canteen Service Station
Coffee Shop Convenience Store School Canteen Variety Store
Bookshop Cafe Delicatessen Pharmacy Food Manufacturer
Restaurant Poultry Shop Sushi Shop
Takeaway Seafood Shop Pub/Hotel/Tavern
Other:
NOTE!
One set of plans must be lodged with this application, drawn to a scale of 1:50 fully dimensioned,
legible and must show floor plan and two sectional elevations accompanied by a site plan drawn
to a scale of 1:200
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Application for Approval of Food Premises Fit-out Plan
Page 2 of 2 FoodPremisesFitout.docx / Building and Environmental Health / Nov-21
A3. Approval Details
Has a Development Application been lodged? Yes No
If ‘Yes’ please provide DA Number
Has a Development Application been issued? Yes No
A4. Land Description
Lot Number Section DP/NPP/SP
Unit/Street No Street
Suburb/Town
A5. Privacy and Personal Information Protection Notice
I declare that all the information in this application is true and correct.
Some information requested by Council for this form constitutes personal information under the Privacy and
Personal Information Protection Act 1998 (NSW).
Purpose of Collection: For Council to carry out certification work for the applicant.
Intended Recipients: Council staff, Government agencies
Supply: Legally required, Council may not be able to accept your application if information is not provided.
Right of Access / Correction: Contact Council (02) 6670 2400 or email tsc@tweed.nsw.gov.au
Storage details: Tweed Shire Council, 10-14 Tumbulgum Road, Murwillumbah NSW 2484
Consequence of non-provision of information: Failure to provide correct business details is a breach of the
Food Safety Standards.
Applicants Name Date
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Application for Approval of Food Premises Fit-out Plan (New South Wales)

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Completed 30 November 2021

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