Compliance Certificate Application

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1. APPLICANT

• Name:

• Postal Address:

2. SUBJECT LAND

• Address:

• Suburb:

• Lot/DP:

• Owner:

• Description of Development:

3. DA/CDC/CC CERTIFICATE NO.

• DA/CDC/CC NO:

• Date of Issue:

  Date

4. TYPE OF CERTIFICATE

• Specified building/subdivision work has been completed and complies with plans and specifications

  Yes

  No

  N/A

• Select Strip footing Frame Floor slab Wet area flashing Sub-floor frame Stormwater drainage Internal drainage External drainage Trade waste Stackwork Plumbing final Pool backwash Other

  • Strip footing
  • Frame
  • Floor slab
  • Wet area flashing
  • Sub-floor frame
  • Stormwater drainage
  • Internal drainage
  • External drainage
  • Trade waste
  • Stackwork
  • Plumbing final
  • Pool backwash
  • Other

• Select Strip footing Frame Floor slab Wet area flashing Sub-floor frame Stormwater drainage Internal drainage External drainage Trade waste Stackwork Plumbing final Pool backwash Other

  • Strip footing
  • Frame
  • Floor slab
  • Wet area flashing
  • Sub-floor frame
  • Stormwater drainage
  • Internal drainage
  • External drainage
  • Trade waste
  • Stackwork
  • Plumbing final
  • Pool backwash
  • Other

• Select Strip footing Frame Floor slab Wet area flashing Sub-floor frame Stormwater drainage Internal drainage External drainage Trade waste Stackwork Plumbing final Pool backwash Other

  • Strip footing
  • Frame
  • Floor slab
  • Wet area flashing
  • Sub-floor frame
  • Stormwater drainage
  • Internal drainage
  • External drainage
  • Trade waste
  • Stackwork
  • Plumbing final
  • Pool backwash
  • Other

• Select Strip footing Frame Floor slab Wet area flashing Sub-floor frame Stormwater drainage Internal drainage External drainage Trade waste Stackwork Plumbing final Pool backwash Other

  • Strip footing
  • Frame
  • Floor slab
  • Wet area flashing
  • Sub-floor frame
  • Stormwater drainage
  • Internal drainage
  • External drainage
  • Trade waste
  • Stackwork
  • Plumbing final
  • Pool backwash
  • Other

• Condition(s) has/have been complied with

  Yes

  No

  N/A

• Give details of the specific condition(s) of development consent OR complying development certificate and detail the matter the condition relates to and the standard/instruments that the matter is required to comply with

5. DETERMINATION CERTIFICATE

• Bathurst Regional Council certifies that:

• The above described building/supervision work has been completed and complies with the attached plans and specifications and the above described aspects of development complies with the prescribed requirement referred to above

  Yes

  No

  N/A

• The above condition(s) has/have been complied with

  Yes

  No

  N/A

• The compliance certificate is REFUSED for the following reasons

  Yes

  No

  N/A

• INSPECTION DATE OF BUILDING/SUBDIVISION WORKS

  Date

• Signature

  Sign

• Issue Date

  Date

• Given to

  Sign

• Add drawing

  Drawing

6. FEES - COUNCIL USE ONLY

• Amount:

• Rec:

• Date

  Date

• Note: Where Council has issued the relevant Construction Certificate NO FEE is payable