Form 61 Non-Compliance Final

                                                                                                                                  Version 2 – March 2013

Form 61—Non-compliance notice

NOTE                                              Notice to builder from the certifier or competent person that work does not comply
1. Builder details                                Name (in full)
If the certifier works for a company, a contact
person must be shown.                              Derek Chart
                                                  Company name if applicable                                Contact person

                                                  Phone no. business hours              Mobile no.                      Fax no.
                                                   0417425011                            0417425011
                                                  Email address
                                                   [email protected]
                                                  Postal address
                                                   6 Joyce Street
                                                   Tewantin 4565
2. Property description                           Street address (include no., street, suburb / locality & postcode)
The description must identify all land the         4 Arkana Drive
subject of the application.
The lot & plan details (eg. SP / RP) are           Noosa Heads                                                           Postcode 4567
shown on title documents or a rates notice.
If the plan is not registered by title, provide   Lot & plan details (attach list if necessary)
previous lot and plan details.                     214RP94023
                                                  In which local government area is the land situated?
                                                    Noosa Council
                                                  Development approval number
                                                   20205107
3. Private certifier                              Name (in full)
                                                   Terry Neller
A copy of this notice must be given to the
private certifier, in accordance with section     Company name if applicable                                Contact person
33(3) of the Building Regulation 2006.             Noosa Building Certifiers                                 Terry Neller
If the certifier works for a company, a contact   Phone no. business hours              Mobile no.                      Fax no.
person must be shown.                              54556081                              0437783608                      54556084
                                                  Email address
                                                   [email protected]
                                                  Postal address
                                                   PO Box 914
                                                   Tewantin Qld 4565
                                                  Licence number
                                                   A921828




LOCAL GOVERNMENT USE ONLY
     Date received                                                                     Reference Number/s