45 Princes Highway, Werribee, Victoria 3030, Australia
PO Box 197, Werribee, Victoria 3030, Australia
(03) 9742 0777
(03) 9742 0817
mail@wyndham.vic.gov.au
ABN: 38 393 903 860
www.wyndham.vic.gov.au
FORM 22
Regulation 147P(1)
Building Act 1993
Building Regulations 2018
APPLICATION TO REGISTER A SWIMMING POOL OR SPA
Please complete form in BLOCK LETTERS
Ownership details:
Name of owner(s) of the land (the property) on which the swimming pool or spa is located
Postal address
Suburb Postcode
Telephone
Email Address
Property Details: (please complete all information known)
Number Street/road
City/suburb/town
Postcode Lot/s LP/PS
Volume Folio Crown allotment Section
Parish County Municipal district
INSTRUCTIONS: This is an editable form that can be filled out online or printed and completed manually. If you fill it
out online, firstly you will need to save the PDF locally, then complete it and attach it to an email to submit.
If you fill it out
manually: Please print and either post it, scan and email or bring it in person to Wyndham City.
Wyndham
45 Princes Highway, Werribee, Victoria 3030, Australia
PO Box 197, Werribee, Victoria 3030, Australia
(03) 9742 0777
(03) 9742 0817
mail@wyndham.vic.gov.au
ABN: 38 393 903 860
www.wyndham.vic.gov.au
Type of swimming pool or spa: (tick box of required information)
Permanent spa
Permanent swimming pool
Relocatable swimming pool
Relocatable spa
For permanent swimming pools and permanent spas, the approximate date that the
swimming pool or spa was constructed
[please provide copies of any relevant building permit if available and/or any other information or
documentation that provides evidence of when the swimming pool or spa was constructed]
For relocatable swimming pools and relocatable spas, the date that the relocatable
swimming pool or relocatable spa was erected
Has any other building work resulted in changes to the barrier since the swimming pool
or spa was constructed or erected?
[if yes, please provide details and copies of any relevant building permit or other documentation]
Fee Payable (gst not applicable) $79.00
Send to: mail@wyndham.vic.gov.au
Privacy Notification:
The personal information requested on this form is being collected by Council in accordance with the Building Act
1993. Your information will be stored in Council’s Customer Database and used to identify you when communicating
with Council and for the delivery of services and information. For further information on how your personal
information is handled, visit Council’s Privacy Policy at https://www.wyndham.vic.gov.au/privacy-policy
OFFICE USE ONLY
Receipt No
Officer Supplying Information
Please allow up to 4 weeks to receive confirmation that your Swimming Pool or Spa has successfully been added to our register.
Wyndham City, 45 Princes
Highway, Werribee 3030
Phone: (03) 9742 0777
Fax: (03) 9742 6355
Credit Card Payment Form - Building Services Only
TO: Wyndham C
ity Council Building Services
From
I declare that the information supplied is true and
correct
Date
Visa
Your contact phone number
Payment for
TYPE OF CARD
Mastercard
Card account number
Expiry date
Full name as it appears on credit card
Full address of card holder
Amount being paid
Receipt required
Yes
No
Email
Your contact phone number
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome