Fillable OUTLINE PLAN APPROVAL // WAIVER Section 176A APPLICANT (Queenstown Lakes District Council New Zealand)

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OUTLINE PLAN APPROVAL // WAIVER Section 176A APPLICANT (Queenstown Lakes District Council New Zealand)

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Page 1/4 // July 2018
REQUEST FOR
OUTLINE PLAN
APPROVAL // WAIVER
Section 176A
APPLICANT // Must be a requiring authority
Postal address supplied must be a valid postal address for the applicant and not for an agent acting on their behalf.
*Requiring Authority:
*Contact Person / All trustee names:
*Postal Address: *Post code:
*Email Address:
*Phone Numbers: Day Mobile:
PLEASE COMPLETE ALL MANDATORY FIELDS* OF THIS FORM.
This form provides contact information and details of your application. If your form does not provide the required information it will be returned to you to
complete. Until we receive a completed form and payment of the initial fee, your application may not be accepted for processing.
CORRESPONDENCE DETAILS // If you are acting on behalf of the requiring authority e.g. agent, consultant or architect
please ll in your details in this section.
Name & Company:
Phone Numbers: Day Mobile:
Email Address:
Our preferred methods of corresponding with you are by email and phone.
The decision will be sent to the Correspondence Details by email unless requested otherwise.
*Attention:
*Postal Address: *Post code:
*Email:
Requiring Authority: Agent: Other, please specify:
Email: Post:
Please select a preference for who should receive any invoices and how they would like to receive them.
Please provide an email AND full postal address.
INVOICING DETAILS //
Invoices will be made out to the requiring authority but can be sent to another party if paying on their behalf.
For more information regarding payment please refer to the Fees Information section of this form.
*Attention:
*Postal Address: *Post code:
*Email:
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 2/4 // July 2018
DETAILS OF SITE // Legal description eld must list legal descriptions for all sites pertaining to the application.
Any elds stating ‘refer AEE’ will result in return of the form to be fully completed.
DETAILS OF SITE // Legal description eld must list legal descriptions for all sites pertaining to the application.
Any elds stating ‘refer AEE’ will result in return of the form to be fully completed.
*Address / Location to which this application relates:
*Legal Description:
Can be found on the Computer Freehold Register or Rates Notice – e.g Lot x DPxxx
DETAILS OF APPROVAL OR WAIVER REQUEST
Designation Number :
Is the proposal consistent with the purpose of the designation? YES NO
Does the proposal comply with the conditions on the designation? YES NO
If no, please elaborate on any breaches of the designation conditions:
Please provide a written description of the outline plan approval or outline plan waiver request, and associated plans/drawings:
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 3/4 // July 2018
FEES INFORMATION
Section 36 of the Resource Management Act 1991 deals with administrative charges and allows a local authority to levy charges
that relate to, but are not limited to, carrying out its functions in relation to receiving, processing and granting of resource consents
(including certicates of compliance and existing use certicates).
Invoiced sums are payable by the 20th of the month after the work was undertaken. If unpaid, the processing of an application,
provision of a service, or performance of a function will be suspended until the sum is paid. You may also be required to make an
additional payment, or bring the account up to date, prior to milestones such as notication, setting a hearing date or releasing the
decision. In particular, all charges related to processing of a resource consent application are payable prior to issuing of the decision.
Payment is due on the 20th of the month or prior to the issue date – whichever is earlier.
If your application is notied or requires a hearing you will be requested to pay a notication deposit and/or a hearing deposit. An
Requiring Authority may not oset any invoiced processing charges against such payments.
Section 357B of the Resource Management Act provides a right of objection in respect of additional charges. An objection must be in
writing and must be lodged within 15 working days of notication of the decision.
If the initial fee charged is insucient to cover the actual and reasonable costs of work undertaken on the application you will be
required to pay any additional amount and will be invoiced monthly as work on the application continues. Please note that if the
Requiring Authority has outstanding fees owing to Council in respect of other applications, Council may choose to apply the initial fee
to any outstanding balances in which case the initial fee for processing this application may be deemed not to have been paid.
LIABILITY FOR PAYMENT – Please note that by signing and lodging this application form you are acknowledging that the Requiring
Authority is responsible for payment of invoices and in addition will be liable to pay all costs and expenses of debt recovery and/or
legal costs incurred by QLDC related to the enforcement of any debt.
MONITORING FEES – Please also note that if this application is approved you will be required to meet the costs of monitoring any
conditions applying to the consent, pursuant to Section 35 of the Resource Management Act 1991.
DEVELOPMENT CONTRIBUTIONS – Your development, if granted, may also incur development contributions under the Local
Government Act 2002. You will be liable for payment of any such contributions.
A list of Consent Charges is available on the on the Resource Consent Application Forms section of the QLDC website. If you
are unsure of the amount to pay, please call 03 441 0499 and ask to speak to our duty planner.
Please ensure to reference any banking payments correctly. Incorrectly referenced payments may cause delays to the
processing of your application whilst payment is identied.
Please reference your payments as follows:
Applications yet to be submitted: RM followed by rst 5 letters of applicant name e.g RMJONES
Applications already submitted: Please use the RM# reference that has been assigned to your application, this will have been
emailed to yourself or your agent.
Please note processing will not begin until payment is received (or identied if incorrectly referenced).
PAYMENT // An initial fee must be paid prior to or at the time of the application and proof of payment submitted.
I conrm payment by:
Bank transfer to account 02 0948 0002000 000 (If paying from overseas swiftcode – BKNZNZ22)
Cheque payable to Queenstown Lakes District Council attached
Manual Payment at reception (can only be accepted once application has been lodged and
acknowledgement email received with your unique RM reference number)
*Payment Reference
*Amount Paid
(For required initial fees refer to website for Resource Consent Charges or speak to the Duty Planner by phoning 03 441 0499)
*Date of Payment
Outline Plan Approval Fee: $1,340
Outline Plan Waiver Fee: $ 530
Please select
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 4/4 // July 2018
APPLICATION & DECLARATION
The Council relies on the information contained in this application being complete and accurate. The Applicant must take all reasonable steps to
ensure that it is complete and accurate and accepts responsibility for information in this application being so.
If lodging this application as the requiring authority:
I/we hereby represent and warrant that I am/we are aware of all of my/our obligations
arising under this application including, in particular but without limitation, my/our
obligation to pay all fees and administrative charges (including debt recovery and legal
expenses) payable under this application as referred to within the Fees Information section.
If lodging this application as agent of the requiring authoirty:
I/we hereby represent and warrant that I am/we are authorised to act as agent of the Applicant in
respect of the completion and lodging of this application and that the Applicant is aware of all of
his/her/its obligations arising under this application including, in particular but without limitation,
his/her/its obligation to pay all fees and administrative charges (including debt recovery and legal
expenses) payable under this application as referred to within the Fees Information section.
I hereby apply for the resource consent(s) for the Proposal described above and I certify that, to the best of my
knowledge and belief, the information given in this application is complete and accurate.
Signed (by or as authorised agent of the Applicant) **
Full name of person lodging this form
Firm/Company Dated
**If this form is being completed on-line you will not be able, or required, to sign this form and the on-line lodgement will be treated as conrmation
of your acknowledgement and acceptance of the above responsibilities and liabilities and that you have made the above representations, warran-
ties and certication.
OR:
PLEASE TICK
PRIVACY INFORMATION
The information you have provided on this form is required so that your application can be processed under the Resource Manage-
ment Act 1991 and may also be used in statistics collected and provided to the Ministry for the Environment and Queenstown Lakes
District Council. The information will be stored on a public register and may be made available to the public on request or on the
company’s or the Council’s websites.
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OUTLINE PLAN APPROVAL WAIVER Section 176A APPLICANT (Queenstown Lakes District Council New Zealand)

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Completed 10 November 2020

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