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Standard Driveway form
Standard Vehicle Crossover Application
[H N " 'SA l OUNCIL
Section 75 Local Government Act (2009)
If access to your property is from a Queensland Government controlled road, you will require approval from the
Department of Transport and Main Roads to complete your crossover construction. Do not submit this application.
A vehicle crossover can only be classified as self-assessable providing that it complies with all of the attached conditions
and the appropriate standard drawings — RS-049 and RS-050 (residential type) or RS-056, RS-056.1 (rural type).
This is a free service.
If you answer 'no' to any of the following condition requirements, or are constructing a crossover that is in an urban area
and not concrete or asphalt/bitumen, this application will not be self assessable and an Operational Works approval is
required. DA Form 1 - Development Application Details is required to be submitted.
1. Applicant details (Applicant must be the property owner or provide written authority to act on behalf of the
owner) _________________________ _
Surname [Given Names
__________ _________________
Postal Address /Q (a/>P-£>y6A#C~
Suburb State Postcode 7*
Business Phone A/H Phone Mobile 040-£ ZW
Email Address j QX\ &LU{\7\CO f> S^F-qjcJrio^ (\OjJ- toPG Fax
2. Property details
Street Address (Lc&^J^XqC 'Te/YKC’Z.
State Postcode *7
i Suburb fJoo&o,
| Property Number (from Rates Notice) IQ- Lot and RP IS sF iM2J£
~ Type of crossover to be constructed
Q^Urban residential crossover (removal/alteration of kerb) - must be constructed as per standard drawing RS-049 and
RS-050
□ Rural crossover (pipe crossing) - must be constructed as per standard drawing RS-056 (Asphalt/gravel surface)
4. Checklist for works
j Is the crossover to be constructed from concrete (includes plain, coloured or exposed aggregate concrete),
[ asphalt or bitumen? Stenciled or raised edges, painted/ sealed surfaces are considered as Non Standard. Df Yes □ No
j Is this going to be the only crossover for this property? S^Yes □ No
• Is the crossover access located so as to provide a clear view of passing pedestrians and vehicles? | □ nq j
! Is the crossover in a location where there are no painted or concrete traffic islands on the road in
I front of the crossover? s □ No
z
! Is the crossover at least 1.0 metre clear of the nearest stormwater pit or power pole? I
s □ No
: Is the crossover in a location where there are no road signs or trees in the way? 0 Yes □ No ;
‘ Is the crossover in a location where its construction will not disturb a survey mark? ; QWes □ No
\ Is the crossover in a location where there are no water meters, fire hydrants or valves in the path
of the crossover? Yes □ No j
Is the crossover in a location where it will not cover the water supply pipe between the main and _ ! S^Yes □ No !
the meter? 9 10
| Is the crossover in a location where there are no sewerage or nholes i //
j of the crossover? .y y M Yes □ No i
! Will the crossover levels match the existing concrete foo ufi'ocr;/ ?> WYes □ No
?Tfc\ No OSa
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Box: .,3..\,^>TZ1...R: ,.3'?.^/$,. Ho
POBox 141 - y-A ynM(g_noosa. gldr^bv. i
NOOSA COtfNCIfc
<3^4-ABN: 97 9S9 214 121 TEWANTIN OLD 4 Ay cau
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4 Cont. Checklist for works
Is the crossover outside of a prohibited location as shown in Standard Drawings number RS-049 and
RS-050 or for rural crossover Standard Drawing number RS-056? □ Yes □ No
Is the crossover in a location where it will not be within 10 metre of the approach side of a bus stop? B^es □ No
Is the crossover in a location where it will not be built over a council easement? GZfYes □ No
Will the crossover be constructed in accordance with the appropriate Standard Drawings -
RS-049 and RS-050 or RS-056, RS-056.1 (including levels and grades)? □ Yes □ No
For a residential crossover is it under 25 metres in length within the road reserve? □ Yes □ No
For a rural crossover is it under 45 metres in length within the road reserve? B'N/A □ Yes □ No
If you are on a corner, will the crossover be constructed in the road described in your street address? S/N/A □ Yes □ No
Note: If you have answered ‘ NO ’ to any of the above condition requirements, the application will
not be self-assessable and an Operational Works approval is required.
5. Declaration of applicant
I/We have read, understood and hereby agree to comply with the attached conditions.
I/We understand that the construction of a crossover is the responsibility of the property owner.
I/We understand that the construction of the crossover is at the risk of the owner.
I/We understand that the removal and reinstatement of the impacted section of the kerb and channel is considered to be
part of the construction of the crossover and therefore the responsibility of the property owner.
I/We understand that if excavation is required l/we should contact “Dial Before You Dig” on 1100.
I/We understand that any damage caused by my activity or damage not notified to council prior to commencing work will
be repaired at my expense.
I/We understand that Noosa Shire Council has the discretion to remove or modify any crossover not constructed or
maintained to council’s satisfaction or if a reasonable objection is raised by a public utility provider or others and that any
such modification will be at my expense.
I/We understand that if l/we do not comply with the standard drawings, conditions and requirements, council may direct
me to undertake modifications of the crossover at my expense.
I/We understand that if l/we fail to comply with a direction from council regarding my crossover, council may attend to any
modifications necessary to ensure compliance with its standard drawings, conditions and requirements at my expense.
I/We agree to indemnify Noosa Shire Council against any claims in negligence or breach of contract relating to the
crossover that l/we construct and maintain.
I/We understand where our crossover is required to be removed or modified by Noosa Shire Council or a public utility
provider there is no expectation or requirement to reinstate the crossover as constructed but rather only to reinstate to a
standard compliant with the standard drawings.
I/We agree that if and when we sell the property, I/We will advise the new owner of the conditions described in this
document, which will then apply to the new owner.
I agree to maintain the vehicular crossover in a safe condition to the satisfaction of the Noosa Shire Council’s Civil Works
Services Manager. If l/we fail to do so or a reasonable objection to the crossover is raised by others, Council may issue a
direction to bring the vehicular access into compliance with Council's standards. Should there be further non-compliance;
penalties under section 75 of the Local Government Act (2009) may apply.
I/We, the applicant, declare that the above information is correct in all respects, at the time of lodgment of this application
with the Noosa Shire Council. Should any of the details given in relation to this application be changed in the future, the
| applicant shall advise the Noosa Shire Council in writing prior to any such change being implemented.
Please print name
A (\
Signature
NOOSA COUNCIL PO Box 141 P. (07) 5329 6500 [email protected]
ABN: 97 969 214 121 TEWANTIN OLD 4565 F. (07) 5329 6501 www.noosa.qid.gov.au