Email to: water.asset@wmk.govt.nz
Company
Mobile Work
Email
Postal Address
Contact Details
Client Details
At what stage is the project? (Investigation, design, tender or construction):
Where is the project located? (Please attach map marking out project zone if available):
Summary of works including any relevant dimensions such as trench depths etc.
(Attach construction drawings if available):
What is the nature of the works to be carried out? (such as the installation of power
, telecom etc.):
What methodology will you be adopting? (such as trenching, drilling, thrusting etc.):
What plant will be on site? (including rated weight of plant):
Please attach any associated plans and drawings that may be of relevance
I have read and understand the terms and conditions outlined in the ‘3 Waters Service Plans Terms and
Conditions’.
Applicant’s signature: Date:
The ‘Critical Services – Permit Application’ will be reviewed by Council and will be assessed as to whether any
critical services will be potentially aected or disrupted by the works. It may, depending on the nature of the works,
be a requirement to have ‘stand over’ monitoring by Council’s Water Unit sta when working near critical assets or
in some cases a pre and post CCTV inspection of the asset may be required.
Written approval is required from Waimakariri District Council to carry out any construction, excavation or building
works that are within 3 metres of any water, wastewater or stormwater critical service.
AUTHORISING OFFICER RECEIPT OF APPLICATION DATE
Critical Services – Permit Application
215 High Street
Priva
te Bag 1005
RANGIORA 7440
New Zealand
If you have any further enquires or require assistance please either email water.asset@wmk.govt.nz or phone 0800 965 468
Phone: 0800 965 468
Fax: (03) 313 4432
water.asset@wmk.govt.nz
waimakariri.govt.nz
Applicant Name
WAT-06-07 / 200115004720
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