Application to Lease or Licence Council Land

 

Complete this online form to apply to lease or licence Council land.

To enable Baw Baw Shire Council to process the application, all required information must be attached to this application and all fields marked as 'required' must be completed.

The application to Lease or Licence Council Land is for private, residential, grazing/farming or commercial use only. If you have any queries please contact Councils Property Management Coordinator 5624 2411.  

Note: This form is fully compatible for use with Chrome, Firefox and Safari web browsers. Some components are not compatible for use with Internet Explorer.

Application to Lease or Licence Council Land

Section A - Application

1. Date * (required)1. Date * (required)

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2. Name of Applicant * (required)

3. Address of Land * (required)

4. Baw Baw Shire Council Liaison Officer * (required)

Section B - Applicant Details

5. Applicant ABN /ACN * (required)

6. Applicant Trading Name (if different from Applicant Name)

7. Registered Legal Entity Address: * (required)

8. Entity Type * (required)

Incorporated Association

Community Group

Sporting Club

Sole Trader

Partnership

Trust

Company

Other

9. If 'other', please specify:

10. Public Liability Insurance * (required)

11. Certificate of Currency * (required)

Contact Person 1 (Licence)

12. Name * (required)

13. Address * (required)

14. Phone * (required)

15. Email * (required)

Contact Person 2 (Accounts)

16. Name * (required)

17. Address * (required)

18. Phone * (required)

19. Email * (required)

20. What is the Applicant's intended use of this land? * (required)

21. Intended Operating Hours * (required)

22. Will storage be required? If yes, how much space is required? (Baw Baw Shire Council makes no guarantee to the provision of storage.) * (required)

23. Is a planning permit required for the intended use? * (required)

24. If not, please attach evidence of same.

25. Is the land fit for purpose for the intended use? * (required)

26. Does the applicant intend to carry out any alteration or addition to the land? If yes, please provide details of costs, timeframes and plans * (required)

27. Please attach supporting documentation

28. Does the applicant intend to invest funds of a capital nature into the land? If yes, please provide details of costs, timeframes, and plans. * (required)

29. Please attach supporting documentation

30. Detail all additional insurances (if applicable)

Membership Numbers (If applicable)

31. Total Members

32. Junior Members

33. Senior Members

34. Are members charged a fee?

Yes

No

35. Junior Fee (If applicable)

36. Senior Fee (If applicable)

37. Family Fee (if applicable)

38. Please detail any other fees charged:

39. Please attach Certificates of Currency for all additional insurances

40. Is the applicant a not-for-profit organisation under Australian Tax Office definitions? * (required)

yes

no

41. Is the applicant a legal entity registered under appropriate legislation (such as the Associations Incorporation Act 1981)? * (required)

yes

no

42. Does the applicant have an Australian Business Number? * (required)

yes

no

43. Does the applicant comply with all relevant legislation governing its activities and hold all licences and registration certificates required for it to operate? * (required)

yes

no

44. Has the applicant complied with all terms and conditions of any previous lease/licence agreement, service level agreement or any other agreement with Baw Baw Shire Council? (If applicable)

yes

no

n/a

45. You will need to download and execute the signatory page to make your application. It can be downloaded from the section titled 'Related Information' at the foot of this page.

46. Please attach your executed signatory page

Type the characters you see in the image below * (Required)

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Privacy Statement 

The personal information on this form is being collected by Council to enable the distribution of rates and charge details to Ratepayers and the preparation of the Municipal Voters Roll. The information will be used by Council for these primary purposes or directly related to municipal purposes only. Council may disclose this information to other authorities including Gippsland Water, South East Water, TXU, Origin Energy and Telstra to enable the provision of services to the property. If these contact details are not kept up to date, rate notices or other municipal information may not reach you and in the case of Rate Notices, interest and legal charges may be incurred if rates are not paid by the due dates. You may apply to Council to gain access to, or for the amendment of personal information held by Council. Information on Council's Privacy Policies can be obtained from Council's Privacy Officer during business hours on 03 5624 2411.