180119004464(v02) Waimakariri District Council
V2 - 1/01/2018 1 of 2 Alternative Solution Engagement
ALTERNATIVE SOLUTION ENGAGEMENT FORM
BC No.
Private Bag 1005, Rangiora 7440
Phone 0800 965 468 (0800 WMK GOV)
Fax 03 313 4432 - waimakariri.govt.nz
THE OWNER
1. Owner’s name:
(Company or organisation name if applicable)
2.
Contact person:
3. Mailing address:
4. Street address / Registered office:
5. Mobile:
Landline:
Email:
OFFICE USE ONLY
Application Solution Application No.:
THE AGENT
PLEASE NOTE - Authorisation is required from the owner to act as agent.
6.
Agent’s name:
(Company or Organisation name if applicable)
7.
Contact person:
8. Mailing address:
9. Street address / Registered office:
10. Mobile:
Landline:
Email:
DESCRIPTION OF WORK
180119004464(v02) Waimakariri District Council
V2 - 1/01/2018 2 of 2 Alternative Solution Engagement
OWNER / AGENT AUTHORISATION
PLEASE NOTE - By entering your name in the box below you are giving your authority for the application to proceed.
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:
CONFIRMATION OF ACCEPTANCE
I hereby engage Waimakariri District Council (“WDC”) to review and assess the alternative solution for compliance to the Building
Code in respect of the work detailed above. The applicant agrees to pay all fees, levies and associated costs incurred by the
WDC and its agents and subcontractors in processing this application. The applicant will pay WDC, its agent or subcontractor
immediately upon receipt of an invoice setting out the fees, levies and costs payable for the work carried out. The applicant agrees
to pay, in addition to the amounts referred to above, all collection costs incurred by the WDC and its agents and subcontractors
arising from the non payment of any invoice. Please complete the authorisation section below.
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)
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.
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome