Approver Details (to be completed by person or organisation who give their approval)
Full Name of person / organisation Position (if applicable)
Email
Daytime phone Mobile phone
Postal Address
Including
Postcode
(if different)
Physical
Address of
Property
Including
Postcode
Are you the owner or occupier of the above property?
Declaration
I/we hereby acknowledge that
1. I/we have been shown a copy of the above application and I am/we are satisfied that the proposal has been
thesifully explained.
2. I/we have been shown and have signed a copy of the site plan, or other relevant plan or drawing, which is
thesiattached (copies of the signed plans are to be lodged with the application).
3. I/we understand that by signing this form a resource consent will not be required for this proposal
By typing your name in the space provided below, you are 'electronically signing' this form.
Full Name of Approver
(or person authorised to sign on behalf) Date:
IT IS NOT APPROPRIATE TO IMPOSE CONDITIONS ON THIS FORM.
PLEASE ADVISE COUNCIL IMMEDIATELY IF YOU HAVE ANY CONCERNS.
HDC is committed to being environmentally sustainable, therefore please submit your application
electronically to:
recordsprocessing@horowhenua.govt.nz
Please remember to attach any supporting documents.
If you require further information please contact a member of our Customer Experience team on:
06 366 0999
