Standard Driveway form

   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