Fillable Form 9: Application for Resource Consent Subdivision and (Waimakariri District Council New Zealand)

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Form 9: Application for Resource Consent Subdivision and (Waimakariri District Council New Zealand)

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Application for Resource Consent
Subdivision and Land Use
Form 9
10 April 2019 1 of 7 Waimakariri District Council
190410053732
Application for Resource Consent Subdivision and Land Use
Lodgement of your application to:
Waimakariri District Council
Private Bag 1005
Rangiora 7440
For planning enquiries please phone or email:
Phone: 0800 965 468
Email: duty.planner@wmk.govt.nz
Electronic applications (up to 22MB) may be lodged via email to RCapplications@wmk.govt.nz
1. Application
About this fo
rm: This form is to be used for an application as required under Section 88 of the Resource Management
Act 1991 and must be accompanied with an assessment of environmental effects, full set of scaled plans, a Certificate
of Title and any other supporting information.
A fixed fee / deposit is required to be paid prior to the processing of the application. An invoice for the fixed fee payable
will be issued once the application has been formally received (unless payment is made at the time of lodgement).
Additional fees will be invoiced in accordance with Waimakariri District Council's fees and charges schedule.
Applicatio
ns are checked for completeness prior to acceptance. Please ensure that you have compiled your documents
carefully to avoid delays in accepting your application
This application is for:
Land Use Consent Subdivision Consent Combined Subdivision & Land Use Consent
2. Applicant Details
Please note: The applicant is responsible for all fees and costs associated with this application, unless specified
otherwise in Section 4
Full Name:
Company / Trust /
Organisation name:
Contact person /
Trustee names
Postal Address:
Email Address:
Mobile No:
The applicant is the: Owner(s) Occupiers (s) Prospective purchaser Director(s) Trustee(s) Other
(please specify below) of the site
If the applicant is not the only owner and occupier of the site, please provide the full name and address of each owner or occupier
(other than the applicant) of the site to which the application relates:
Full Name Address
10 April 2019 2 of 7 Waimakariri District Council
190410053732
Application for Resource Consent Subdivision and Land Use
3. Agent / Consultant
Name of Agent
Company (if applicable)
Postal Address:
Email Address:
Mobile No:
4. Invoicing details
All consent related invoices to be made out to:
Applicant Agent Other (specify below)
Name:
Company (if applicable)
Postal Address:
Email Address:
Mobile No:
Please note: Any refund will only be paid to the receipted name on the invoice
5. The Location/Site
This application relates to the property located at the below location(s):
Street Addre
ss
Legal description
General description*
I have provided a Certificate of Title (Computer Register) less than 3 months old, INCLUDING a copy of any
consent notice, covenant or other encumbrance to which the Council is a party.**
I request that the Council obtain a copy of the Certificate of Title (Computer Register) and any relevant
encumbrances from Land Information New Zealand and on-charge the cost to me.
*Describe the site including its location, as it is commonly known and in a way that will enable it to be easily identified
(eg the name of any relevant stream, river or other water body to which the application relates, proximity to any well-
known landmark etc) and its natural and physical characteristics and any adjacent uses that may be relevant to the
consideration of the application.
**Notes:
• These docu
ments can be obtained from Land Information New Zealand:
https://apps.linz.govt.nz/survey-
titles/order-copy
• If a Certificate of Title is not yet available, include details of relevant lot numbers and subdivision consent
numbers. If you are purchasing a lot from a new subdivision, please provide a copy of your Sale & Purchase
Agreement.
10 April 2019 3 of 7 Waimakariri District Council
190410053732
Application for Resource Consent Subdivision and Land Use
6. The Proposal
The activity
to which the application relates (the proposed activity) is as follows (describe the proposed activity, using
additional paper if required):
7. Pre-application discussions
Was there any pr
e-application advice / discussion prior to this application being lodged?
Yes No
If Yes, what was the Planners name?:…………………………………………
8. Attachments
I/We attach the following documents:
Assessment of Environmental Effects (AEE)
An assessment of the proposed activity’s effect on the environment that—
(a ) includes the information required by clause 6 of Schedule 4 of the Resource Management Act 1991; and
(b) addresses the matters specified in clause 7 of Schedule 4 of the Resource Management Act 1991; and
(c) includes such detail as corresponds with the scale and significance of the effects that the activity may have
on the environment.
An assessment of the proposed activity against the matters set out in Part 2 of the Resource Management
Act 1991.
An assessment of the proposed activity against any relevant provisions of a document referred to in section
104(1)(b) of the Resource Management Act 1991, including the information required by clause 2(2) of Schedule 4
of that Act.
Other Information:
A current search of the Certificate of Title (within last 3 months) (see section 5 above)
Full Details of the proposal
Scaled application plans
Sufficient detail to satisfy the requirements of the National Environmental Standard for Assessing & Managing
Contaminants in Soil to Protect Human Health (where relevant). (See section 11 of this form below)
Section 106 assessment (subdivision consent application only)
Any further information required to be included in this application by the district plan, the regional plan, the
Resource Management Act 1991, or any regulations made under that Act.*
10 April 2019 4 of 7 Waimakariri District Council
190410053732
Application for Resource Consent Subdivision and Land Use
* This information should include (if applicable) the information required by clauses 10, 11 and 13 of Form 9 –
Application for Resource consent (or fast-track consent) of the Resource Management (Forms, Fees, and Procedure)
Regulations 2003 and should be listed in the AEE.
Additional requirements for subdivision consent applications:
I attach information that adequately defines the following:
(a) the position of all new boundaries; and
(b) the areas of all new allotments;* and
(c) the locations and areas of new reserves to be created, including any esplanade reserves and esplanade
strips; and
(d) the locations and areas of any existing esplanade reserves, esplanade strips, and access strips; and
(e) the locations and areas of any parts of the bed of a river or lake to be vested in the territorial authority under
section 237A of the Resource Management Act 1991; and
(f) the locations and areas of any land within the coastal marine area (which is to become part of the common
marine and coastal area under section 237A of the Resource Management Act 1991); and
(g) the locations and areas of land to be set aside as new roads.
* Omit thi
s paragraph if the subdivision involves a cross lease, company lease or a unit plan.
9. Other Activities or Applications
Are there any other activities that are part of the proposal to which this application relates? Yes No
If Yes, incl
ude a description of the other activities in the AEE*
Are additional resource consents are needed for the proposed activity? Yes No
If Yes,
have you applied for, or are required to apply for, any other resource consents for this project, either from the
Waimakariri District Council or Environment Canterbury, and if so, what type?
Has been
applied for:
Is required to
be applied for:
Has been
obtained:
Reference No.
(if applicable)
Waimakariri District Council Subdivision
Consent
Land Use Consent
Environment Canterbury Water Permit
Discharge Permit
Coastal Permit
Have you applied for a Project Information Memorandum (PIM) or a building consent for this project? Yes No
If Yes, what i
s the PIM/BC number
?
* If any ac
tivities are permitted activities, explain how the activity complies with the requirements, conditions, and
permissions for the permitted activity so that a resource consent is not required for that activity under section 87A(1) of
the Resource Management Act 1991.
10. National Environment Standard (NES)
This sect
ion relates to the National Environmental Standard for Assessing & Managing Contaminants in Soil to Protect
Human Heath (NES). www.mfe.govt.nz/laws/standards/contaminants-in-soil
10 April 2019 5 of 7 Waimakariri District Council
190410053732
Application for Resource Consent Subdivision and Land Use
The NES includes regulations controlling soil disturbance, change of use, subdivision, and removal/replacement
of fuel storage systems on properties which have been used either now or in the past for a hazardous activity or
industry (known as HAIL) that may have resulted in contamination of the soil. The table below determines whether the
NES applies to your proposal.
Is the application site listed on Environment Canterbury’s Listed Land Use Register (LLUR)?
www.llur.ecan.govt.nz
If YES. Please include a copy of the LLUR statement with your application.
Yes No
If the site is not listed on the LLUR, is an activity described on the Hazardous Substances and
Industries List (HAIL) currently being undertaken on the piece of land to which this application
relates, or is it more likely than not to have ever been undertaken on the land?
The HAIL list is available to view at: www.mfe.govt.nz/laws/standards/contaminants-in-soil
Yes No
Type of HAIL activity: …………………………………………………………………………………………………………..
If the answer to either of the above questions is YES, then the NES will apply, depending on the type of
activity. Please identify whether the application involves the activities below.
Note: If the answer to both of the previous questions is No, you do not need to answer the remaining questions in this section)
Does the application involve subdivision of the land? Yes No
Will the proposed activity involve the disturbance of more than 25m
3
of soil (per 500m
2
of
disturbed area)?
Volume of soil disturbed: ………………………
Yes No
Will the proposed activity involve the removal of more than 5m
3
of soil (per 500m
2
of disturbed
area) from the site?
Volume of soil removal: …………………………
Yes No
Does the application involve changing the use of the land to one which, because the land has
been subject to a HAIL activity, is reasonably likely to harm human health? (e.g. service station
to office, orchard to residential lots)
Yes No
Does the application involve replacing or removing fuel storage systems or parts of it? Yes No
If the answer to any of the above activity questions is also YES, then the NES will apply and you will need to
establish whether the proposed activity complies with the NES.
• Subdividing or changing the land use will require resource consent if the permitted activity requirements of
the NES are not complied with. These include provision of a Preliminary Site Investigation carried out by a
suitably qualified and experienced practitioner.
• Soil disturbance or removal exceeding the specified volumes require resource consent.
• Removal of replacement of a fuel storage system will require consent if the permitted activity requirements
of the NES are not complied with.
Does the proposed activity require resource consent under the NES?
If YES, the assessment of the application under the NES must be provided as part of your AEE.
A Detailed Site Investigation may be required.
Yes No
11. Notification
Are you requesting the application to be publicly notified? Yes No
Have all
the persons you consider to be adversely affected given their written approval to the proposal?*
Yes No
*Ensure any Written Approval forms and all application plans have been completed & signed and provided as part of
this application.
10 April 2019 6 of 7 Waimakariri District Council
190410053732
Application for Resource Consent Subdivision and Land Use
12. Fees & Charges
I/We enclose the required processing fee of:
(see Waimakariri District Council fees and charges schedule)
$
I/We understand that as the applicant I am/we are responsible for payment of all fees associated with this
application. The payment terms for processing fees and those relating to disbursements, hearings and additional
charges are payable by the 20
th
of the month following the month in which the invoice is issued.
I/We understand that the processing fee must be paid before processing of the application will start.
I/We understand that the fees paid on lodgement are a fixed fee (where indicated) and that the Council is able
to charge additional fees to recover actual and reasonable costs.
I/We agree to pay according to those terms for any goods or services Waimakariri District Council supplies for
processing this application and should failure to meet the terms of trade result in debt recovery and/or legal
proceedings, any costs incurred in the collection of the debt will be payable by me/us.
I/We understand where an invoiced amount has not be paid by the stated due date, the Council may commence
debt recovery action. The Council reserves the right to charge interest, payable from the date the debt became
due, and recover the costs it incurs in pursuing recovery of the debt.
13. Privacy Information
All t
he information on this form is required to be provided under the Resource Management Act 1991 for Waimakariri
District Council to process your application.
Under thi
s Act this information has to be made available to members of the public, including business organisations and
the media. The information contained in this application may also be made available to other departments of the Council.
If there is commercially sensitive information in the proposal, please let us know.
You have t
he right to access the personal information held about you by the Council which can be readily retrieved and
you can request that the Council correct any personal information it holds about you.
14. Declaration
I/We have completed all relevant sections of this form and understand that my application may be returned as
incomplete if it does not include all the relevant information.
I/We understand that the fees paid on lodgement are a deposit only (unless charged as a Fixed Fee as per the
Councils Fees & Charges Schedule) and that the Council will invoice all costs actually and reasonably incurred
in processing this application.
All of the information provided with this application is, to the best of my knowledge, true and correct. I/We
understand that all information submitted as part of an application is required to be kept for public record,
therefore the public (including business organisations and other areas of the Council) may view this application,
once submitted. It may also be made available to the public on the Councils website. .
Signature of applicant …………………………………………………………………………………………………………
(or person authorised to sign on behalf of applicant)*
Print Name: …………………………..………………............... Date ……………………………………………………….
* 1. Signatur
e not required if lodging form electronically
2. if you are signing this application on behalf of a company/trust/or other entity (the applicant), by signing this
form you are declaring that you are duly authorised to sign on behalf of the applicant to make such an
application.
10 April 2019 7 of 7 Waimakariri District Council
190410053732
Application for Resource Consent Subdivision and Land Use
15. Notes to applicants
1. You must include all information required by this form. The information must be specified in sufficient detail
to satisfy the purpose for which it is required.
2. You may apply for two or more resource consents that are needed for the same activity on the same form.
If you lodge the application with the Environmental Protection Authority, you must also lodge a notice in
Form 16A at the same time.
3. If your application is to the Environmental Protection Authority, you may be required to pay actual and
reasonable costs incurred in dealing with this matter (see section 149Z of the Resource Management
Act 1991).
16. Further Information for applicants
1. Al
l applicants are asked to check the accuracy of the information supplied. Inaccuracies in information supplied
can cause difficulties at a later date, such as additional costs, delays and legal proceedings initiated by the Council
and/or by other persons.
2. If resource consent is granted, the applicant has a legal obligation to comply with any conditions of the consent.
3. The required Application Fee/deposit will be invoiced and emailed (if applicable) upon formal acceptance of the
application. Please note that any fee is required to be paid prior to the processing of any application.
4. The application for resource consent under the Resource Management Act 1991 is separate from and in addition
to any building consent application required under the Building Act 2004 and any consents, approvals or licences
required under any other legislation. Any application for building consent must be applied for separately.
5. The written approval of persons the Council considers may be adversely affected by the proposal may be required
as part of the application, if it is to be processed on a non-notified basis. This will be determined after the
application has been lodged and assessed. Pre Application consultation with neighbours and other affected
persons is at the discretion of and responsibility of the applicant.
6. Under section 88 of the Resource Management Act 1991, if your application is deemed incomplete, it may be
returned to you. If additional information is required, you will be advised and processing of the application will be
suspended until the information is received. To avoid any delays it is in your best interests to submit a complete
application.
7. Mo
nitoring Fees – Please note that if this application is approved you will be required to meet the costs of
monitoring undertaken by Council pursuant to section 35 of the Resource Management Act 1991, in accordance
with section 36 of that Act.
8. De
velopment Contributions – Your development, if granted, may also incur development contributions under
the Local Government Act 2002 in accordance with the Council’s Development Contributions Policy. Any
development contributions payable will be invoiced to the applicant. For any subdivision consent, these
development contributions are invoiced at the time a section 224 application is lodged.
12. The Waimakariri District Council Resource Management Fees & Charges Schedule may be viewed at:
https://www.waimakariri.govt.nz/services/fees-and-charges/resource-management-fees-and-charges
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Form 9: Application for Resource Consent Subdivision and (Waimakariri District Council New Zealand)

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