PLEASE TICK
I/We understand that if the consent authority determines the activity is a deemed permitted boundary activity under section 87BA
of the Act, written approval cannot be withdrawn if this process is followed instead.
PLEASE TICK
PLEASE TICK
RESOURCE CONSENT APPLICANT’S NAME AND/OR RM #
AFFECTED PERSON’S DETAILS
WHAT INFORMATION/PLANS HAVE YOU SIGHTED
DETAILS OF PROPOSAL
I/We
Are the owners/occupiers of
I/We hereby give written approval for the proposal to:
at the following subject site(s):
I/We understand that by signing this form Council, when considering this application,
will not consider any eects of the proposal upon me/us.
I/We have sighted and initialled ALL plans dated
and approve them.
Page 1/2 // October 2017
Resource Management Act 1991 Section 95
AFFECTED PERSONS
APPROVAL
FORM 8A
APPROVAL OF AFFECTED PERSONS
A
B
C
D
Name (PRINT)
Contact Phone / Email address
Signature Date
Name (PRINT)
Contact Phone / Email address
Signature Date
Name (PRINT)
Contact Phone / Email address
Signature Date
Name (PRINT)
Contact Phone / Email address
Signature Date
The written consent of all owners / occupiers who are aected. If the site that is aected is jointly owned, the written consent of all
co-owners (names detailed on the title for the site) are required.
Note to person signing written approval
Conditional written approvals cannot be accepted.
There is no obligation to sign this form, and no reasons need to be given.
If this form is not signed, the application may be notied with an opportunity for submissions.
If signing on behalf of a trust or company, please provide additional written evidence that you have signing authority.
Queenstown Lakes District Council
Private Bag 50072, Queenstown 9348
Gorge Road, Queenstown 9300
P: 03 441 0499
E: resourceconsent@qldc.govt.nz
www.qldc.govt.nz
Page 2/2 // October 2017
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