Title Page

  • Conducted on

  • Prepared by

  • Written notice to undertake permitted plantation forestry activities (afforestation, earthworks, river crossings, forestry quarrying and/or harvesting) as defined in Regulation 3 of the Resource Management (National Environment Standards for Plantation Forestry) Regulations 2017 (NES-PF).


  • First and Middle Names

  • Last Name/company

  • Contact Person (if a company):

  • Postal address

  • Company contact number

  • Email address:


  • Company Name

  • Contact Person

  • Contact Number

  • Email Address

  • Postal Address


  • Description of activity

  • Copy of wilding tree risk calculator calculation sheet and score (Regulation 11(4)) ATTACHED

  • Proposed setbacks (including a description of how these were calculated (Regulation 10(1)(a)) ATTACHED

  • Council will request a copy of the quarry erosion and sediment management plan. You may upload the plan with this form if you wish

  • Proposed setbacks (including a description of how these were calculated (Regulation 51(1)(a)) ATTACHED

  • Please upload a map detailing where earthworks are to be carried out

  • Are you constructing a river crossing

  • Are you removing a river crossing

  • Please upload a map showing the location of the river crossing

  • Please upload a map identifying the harvesting location

LOCATION OF WHERE THE ACTIVITY WILL OCCUR (REGULATIONS 10(1)(a), 25(1)(a), 38(1)(b), 52(1)(a), 64(1)(a))

  • Forest Name

  • Certificate of Title Number

  • Legal Description of Property

  • Address of property

PLANNED START DATE OF THE ACTIVITY(REGULATIONS 10(1)(b), 25(1)(b), 38(1)(a), 52(1)(b), 64(1)(b))

  • Planned start date of works

  • Planned end date of works

  • Is notice being provided to Council at least 20 and no more than 60 working days before the planned start date for afforestation / river crossings / forest quarrying

  • Is notice being provided to Council 2 days prior to the start date for earthworks and/or harvesting for salvage operations

  • I/we the under signed acknowledge that the permitted activity is to be held in my/our name as described above and accept liability for all charges associated with the monitoring of this permitted activity

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