Application for Toby Locate
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
I/We, the undersigned, hereby apply for a request for Waitomo District Council to locate a Water Toby.
Property Location
Address:
To: Water Services Engineer, Waitomo District Council
I, the undersigned, agree to the terms and conditions below on this application.
Name:
Organisation:
Postal Address:
Phone:
Home Work Mobile
Email:
Applicants Signature:
Ofce Use Only
Please read the Terms and Conditions below
Date:
Staff Initials: Permit Fee: $
GL Code: (Please tick)
Te Kuiti (720 08270) Mokau (721 08270) Piopio (722 08270) Benneydale (723 08270)
Date Fee Paid:
1. This service will be carried out within 72 hours upon receipt of this application and the accompanied
payment.
2. Payment for this service MUST be received in full on application – no service will be provided without
payment.
3. Should the applicant require that the application fee be invoiced, a valid debtors account must be
held. Alternatively the applicant can make an application to Waitomo District Council to obtain an
account (subject to normal credit criteria and Council approval which will take up to ten working days
to process – please note that Council have the right to decline an application should it not meet the
Council requirements)
4. The Water Services Engineer MUST be informed on all applications.
Upon receipt, this application must be scanned and emailed to the Water Service Engineer direct:
lesc@waitomo.govt.nz
Council Stamp
Document Number 358619
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