APPLICANT // Must be a person or legal entity (limited liability company or trust). Full names of all trustees required.
CORRESPONDENCE DETAILS // If different than above – E.g. consultant, agent or architect
INVOICING DETAILS // The invoices will be sent to this postal address
Applicant’s full name:
Company / Trust:
Contact Person / All trustee names:
Address: Post code:
Email Address:
Phone Numbers: Day Mobile:
OR:
Name & Company:
Phone Numbers: Day Mobile:
Email Address:
Attention:
Address: Post code:
Email:
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.
PROJECT DETAILS
Project Name / Title:
Project (site) address:
Page 1/4 // July 2018
APPLICATION FORM
URBAN DESIGN
PANEL
PROJECT DETAILS CONTINUED
INFORMATION REQUIRED
Description of project:
Has the application been reviewed by the urban design panel before? (Please delete as applicable)
Yes No If yes, what date was the meeting held?
Please make sure that your application is complete. If you are unsure of what your application should include, you can
view examples of previous applications at the Council ofces.
In particular, please ensure that your application includes contextual information, including pedestrian and vehicle ow
paths and photographs of neighbouring properties.
An electronic copy of the following:
Your completed application form
Site plans including building setbacks required by the District Plan
Elevations (complete set showing all relevant details such as proposed signage, height limits and recession planes)
Perspective drawing showing buildings forms and setting (and excluding landscaping that obscures any part of the
building)
Cross sections (including land gradients of abutting properties)
Landscaping plans
Plan showing pedestrian or vehicle ow paths through the property and to and from nearby destinations.
Photos of neighbouring properties and street elevation photos showing all properties within approximately 75 metres
of the project site.
An outline of the design brief and a brief description of the design principles that generated the proposal
A list of any infringements of District Plan Rules
A list of the main materials, colours and textures to be used
A copy of the District Plan Zoning Map with the site marked
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
PRIVACY INFORMATION
FEES
The information you have provided on this form is required so that your application can be processed under the Resource
Management 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.
The cost to have your proposal put before the Urban Design Panel is $250. This is a xed fee for proposals yet to have a
resource consent lodged.
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).
An initial fee for processing this application will be charged at the time of lodgement in accordance with QLDC’s fee
schedule. This initial fee must accompany your application for processing to commence. If the initial fee is insuf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 Applicant 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.
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.
LIABILITY FOR PAYMENTPlease note that by signing and lodging this application form you are acknowledging that
the Applicant 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.
PAYMENT // A deposit 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 reference RMUD and the first
5 letters of applicant name. (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 acknowledgment email received with your unique RM reference number)
Amount Paid: (For required deposit fees refer to website for Resource Consent Charges)
Date of Payment:
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
Please select
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 Applicant:
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 the Fees Information section.
If lodging this application as agent of the Applicant:
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 the Fees Information section.
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, warranties and certication.
OR:
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
click to sign
signature
click to edit
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