This form is to be used by territorial authorities to request the approval of the Minister for Building and
Construction to designate an area for emergency management of buildings.
Email the completed form to, subject line:
TArequest for designation of area approval.
Territorial authority: [if a joint application include all territorial authorities]
Lead contact person: [name, role, territorial authority]
Lead contact phone numbers:
Lead contact email:
Emergency event: [describe the emergency event ie.region/town/location, type of event, impact of event]
Urgency to start designation of area: [give an indication to the urgency for this designation, providing a preferred start date]
Area of proposed designation: [clearly identify the exact area for designation, see notes]
Designation area short-name: [provide a short-name the designation can quickly be referred to as]
Request for approval
to designate an area
Subpart 6B of Part 2 of Building Act 2004
TA request approval for designation of area
Confirm the designation of area satisfies the following criteria: [tick all that apply]
 in the public interest and
necessary or desirable for the protection of: [tick all that apply]
 persons, from injury or death
 buildings, from damage or disruption to their use
 public thoroughfares, from disruption
 critical infrastructure, from damage or disruption to its operation or use
 persons or buildings, from the effects of the insanitary condition (if applicable) of a building in the relevant area
Provide details on satisfying the above criteria selected: [briefly describe]
Indicate the consideration given to the following in proposing this designation of area:
(a) The scale and degree of the impact of the emergency and of its ongoing effects on buildings: [briefly describe]
(b) The likelihood of a further emergency or any other relevant event occurring that could cause: [tick which apply]
 (i) buildings in the relevant area that pose increased or additional risks [briefly describe, if selected]
 (ii) land in the relevant area that poses a risk to a building [briefly describe, if selected]
(c) The principle that it is preferable that risks be managed, if possible without the exercise of powers: [tick to confirm
If any attachments have been provided with this application: [please list with a short description for each one]
Notes: When describing the area for designation, it is important the information can be clearly conveyed to all interested
parties. Usually this is in words identifying the names of roads or landmarks or geographical features such as a river and
preferably using commonly known terms or names that can be subsequently located on an official map. The area description
needs to identify where the designated area begins and ends, ensuring any possible ambiguity or confusion is avoided.
Aclearly marked-up map can be attached, but it is important that any public notification of the designation of area matches
theinformation stated in this application.