Title Page
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Applicant Name
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Address of Works
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Date of Application
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Builder
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Site Contact & Phone Number
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Permit Inspected by:
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Date of Inspection
Assets Adjacent to Property - Check boxes if present
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Footpath
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Condition Comments
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Photos if relevant
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Road Wearing Course (Asphalt or Spray Seal)
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Condition Comments
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Photos if relevant
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Kerb and Channel
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Condition Comments
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Photos if relevant
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Rain Garden
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Condition Comments
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Photos if relevant
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Nature Strip
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Condition Comments
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Photos if relevant
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Stormwater
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Condition Comments
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Photos if relevant
Additional Information
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Additional Condition Comments
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Additional Condition Photos
Audit Completion
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Have all sections been completed and all assets inspected for damage?
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Signature of Inspector
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Date and Time Audit Completed
