Property Services Application for Lease/Licence of Telecommunications Site

(This form is current for the period 1 July 2024 – 30 June 2025)

Applicant Details

Company/Organisation *

ABN/ACN *

Postal Address *

Postcode *

Contact Person *

Position in Company *

Email Address *

Business Phone *

Mobile *

Please provide the following “subject property” details

Property Address *

Postcode *

Lot (s) *

DP(s) *

Lease/Licence Term *

Proposed Rent pa *

Increases pa *

Please attach description of facility and location plan *

Browse

Declaration

I hereby make application for Council to undertake preliminary investigations in relation to the “subject property” as described and shown in the attached plan. I understand that this application must be accompanied by a non-refundable Administration Fee of $2,215.00 (GST inclusive). For further information please contact Council on 9847 6666.

I understand that payment of this fee provides for the preliminary investigation services to be undertaken by Council, and may include, but not be limited to:
- Determine operational and community requirements of the property (including land classification under part 2 of the Local Government Act),
- Seek advice from relevant Council Divisions, and other stakeholders in the property
- Determine whether the proposal for the property fits in with the strategy (which may or may not have been formulated) for the property, and
- If considered appropriate to the matter, prepare a report to Council seeking, the appropriate resolution by Council to proceed.

I understand that if Council resolves to proceed further with the proposal that additional costs may be incurred by me for fees, charges and other direct costs associated with the application. *

Name *

Date *

Signature *

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I understand that the payment of this fee does not create any contractual relationship, nor does it guarantee that Council or any Government Authority will provide any necessary approvals. *

Privacy Notification

Information provided to Council in any form (eg verbal, written, electronic), may be made available to third parties in accordance with relevant legislation. Council reserves the right to reproduce any correspondence or submission.

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