Waimakariri District Council
180119004467[v02
]
V2 - 1/01/2018
1 of 2 Building Consent Cancellation Notication
BUILDING CONSENT CANCELLATION NOTIFICATION
BC No.
Private Bag 1005, Rangiora 7440
Phone 0800 965 468 (0800 WMK GOV)
Fax 03 313 4432 - waimakariri.govt.nz
THE OWNER
4. Owner’s name:
(Company or organisation name if applicable)
5.
Contact person:
6. Mailing address:
7. Street address / Registered office:
8. Mobile: Landline:
Email:
If the ownership has changed since the application was made, new evidence of ownership will need to be provided
(i.e. Certicate of Title).
THE AGENT
PLEASE NOTE - Authorisation is required from the owner to act as agent.
9.
Agent’s name:
(Company or Organisation name if applicable)
10.
Contact person:
11. Mailing address:
12. Street address / Registered office:
13. Mobile: Landline:
Email:
THE BUILDING
1. Site address:
(Street / Road / Township)
2.
Legal description of the land where the building is located:
Lot:
DP: 3. Other:
14. I wish to receive my approved documentation in the following format:
PLEASE NOTE - If USB or Hard Copy please conrm if you wish to pick it up from the council or have it posted/couriered (couriered will incur
an additional cost).
Electronically via Sharele Transfer Portal
(1)
USB: (post) OR (pick-up) OR (courier)
Hard copy: (post) OR (pick-up) OR (courier)
Waimakariri District Council
180119004467[v02
]
V2 - 1/01/2018
2 of 2 Building Consent Cancellation Notication
OWNER / AGENT AUTHORISATION
PLEASE NOTE - By entering your name in the box below you are giving your authority for the application to proceed.
Please cancel my Building Consent Application in regard to the above property, as it is not my intention to proceed
with the building work. I agree to pay any outstanding fees for processing the application to date, plus costs
associated with the cancellation.
Name: Date:
I am the
Owner
Agent
Note: If acting on behalf, by entering your name above you hereby declare that you are authorised to act as Agent for
the Owner.
NB: Ensure Agent Authorisation section is completed - see below.
AGENT AUTHORISATION
(TO BE AUTHORISED BY OWNER)
PLEASE NOTE - By entering your name in the box below you are giving your authority for this application to proceed.
I authorise
to act as Agent on my behalf for this
Building Consent application under Sections 33 and 45 of the Building Act 2004.
With respect to this Building Consent application, I authorise
to act
as Agent on my behalf for the application for Code Compliance Certicate under Section 92 of the Building Act 2004.
Name (Owner): Date:
OFFICE USE ONLY
Further information required? Yes No
Application accepted? Yes No Further information provided? Yes No
Date of acceptance:
Officer:
All the relevant information on this form is required to be provided under the Building Act and Resource Management Act for the Building Unit
to process your application. Under these Acts this information has to be made available to members of the public. The information contained in
this application may be made available to other units of the Council. You have the right to access the personal information held about you by the
Council that can be readily retrieved. You can also request that the Council correct any personal information it holds about you.
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