APPLICANT //
*Applicant’s Full Name / Company / Trust:
*Contact Person / All trustee names:
*Postal Address: *Post code:
*Email Address:
*Phone Numbers: Day Mobile:
The Applicant is:
Owner Prospective Purchaser (of the site to which the application relates)
Occupier Lessee
Other - Please Specify
INVOICING DETAILS //
Invoices will be made out to the applicant but can be sent to another party if paying on the applicant’s behalf.
Please select a preference for who should receive any invoices and how they would like to receive them.
*Attention:
*Postal Address: *Post code:
*Email:
Applicant: Agent: Other:
Email: Post: Please Specify:
For more information regarding payment please refer to the Fees Information section of this form.
Please provide an email and FULL postal address.
See our website for pre-application costs and general fees and charges.
Must be a person or legal entity (limited liability company or trust).
Full names of all trustees required.
Postal address supplied must be a valid postal address for the applicant and not for an agent acting on their behalf.
Page 1/4 // July 2017
RESOURCE CONSENT
PRE-APPLICATION
MEETING REQUEST
Please complete all mandatory elds* 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, your application may not be accepted for processing.
CORRESPONDENCE DETAILS // If you are acting on behalf of the applicant 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.
DETAILS OF SITE
*Address / Location to which this application relates:
*Legal Description: (
Can be found on the Computer Freehold Register or Rates Notice – e.g Lot x DP xxx)
PROPOSAL
Land use Subdivision Other, please specify
Applicant name:
Agent name:
Advisor 1 name: Expertise:
Advisor 2 name: Expertise:
Advisor 3 name: Expertise:
Advisor 4 name: Expertise:
DESCRIPTION OF PROPOSAL
Please provide a description of the proposal and, if known, a list of consent, permit and licensing requirements.
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 2017
WHO WILL BE ATTENDING THE MEETING
PROPOSAL
SPECIFIC ISSUES OR TOPICS FOR DISCUSSION
Please also identify which QLDC staff you would like to attend- eg., planner only; resource management engineer etc.
SUPPORTING DOCUMENTS
Please attach supporting documents here including draft assessment of environmental effects, draft application
for resource consent, draft plans, certicates of title and any other information that would be useful for the pre-
application meeting.
DESCRIPTION OF PROPOSAL CONTINUED
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 2017
If the outcome of your pre-application meeting results in a resource consent being lodged, an initial fee for
that consent applies.
The
rst hour spent reviewing pre-application documents or meeting with you will be free; thereafter any assessment,
meeting or administrative time will be invoiced at the relevant hourly rates. A list of Consent Charges and hourly rates can
be found on the Resource Consent Application Forms section of the QLDC website. Please note the free hour refers only
to Council ofcers time; if an external consultant such as a landscape architect or other technical specialist (e.g noise or
trafc specialist) is required, their time will be charged.
Invoices will be sent monthly and are payable by the 20th of the month after the work was undertaken. If unpaid, the
pre-application assessment, provision of a service, or performance of a function will be suspended until the sum is paid.
Please be advised there may be a delay in billing for external consultants’ time; Council has to receive invoices for that
time before passing any applicable charges to yourself.
After pre-application discussions, if you decide to submit a resource consent an initial fee will be required and any associ-
ated charges will be billed separately from your pre-application charges.
Payment
Payment for pre-application invoices can be made by phoning or visiting one of our ofces, please make sure you quote
your pre-application reference number shown on your invoice starting PA.
Payment can also be made via bank deposit or online banking. Please ensure to reference any banking payments cor-
rectly with the PA# shown on your invoice or the Invoice number. Incorrectly referenced payments may cause delays to the
assessment of your pre-application whilst payment is identied.
LIABILITY FOR PAYMENT
Please 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.
FEES INFORMATION
TERMS AND CONDITIONS
1. The purpose of a pre-application meeting is to facilitate communication between applicants and the council so that the
applicant can make informed decisions about applying for consents, permits or licenses.
2. The views expressed by council staff in or following a pre-application meeting are those officers’ preliminary views, made in
good faith, on the applicants proposal. The council makes no warranty, express or implied, nor assumes any legal liability or
responsibility for the accuracy, correctness, completeness or use of any information or views communicated as part of the
pre-application process.
3. The applicant is not required to amend their proposal to accommodate the views expressed by council staff, nor to comply
with any suggestions made by council staff. Further, it remains the applicant’s responsibility to get their own professional
planning and legal advice when making any application for consents, permits or licences, and to rely solely on that advice, in
making any application for consents, permits or licenses.
4. To the extent permissible by law, the council expressly disclaims any liability to the applicant (under any theory of law
including negligence) in relation to any pre-application process. The applicant also recognises that any information it
provides to the council may be required to be discussed under the Local Government Official Information and Meetings Act
1987 unless there is a good reason to withhold the information under that Act).
5. Any assessment and administration time spent beyond the first free hour will be charged at the relevant hourly rates of each
attendee.
6. For a full list of fees and charges refer to payment, fees and charges as set out on Queenstown Lakes District Council’s
Website.
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 2017
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 within 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 within 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, warran-
ties and certication.
OR:
SEND
Email this form and supporting documents to resourceconsent@qldc.govt.nz, or drop in to the Duty Planner of the
resource consents team at the rst oor of 74 Shotover Street, Queenstown; or 33-35 Reece Crescent, Wanaka
I have read, understand and accept the terms and conditions set out above.
PLEASE TICK
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 5/4 // July 2017
click to sign
signature
click to edit
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