Sch 1Forms

Schedule 1 — Forms

[List of Forms deleted: SL 2020/213 r. 5(1).]

[r. 43, 46, 63, 64 and 68]

[Heading amended: SL 2020/213 r. 5(2).]

Form 1. Application for Grant or Renewal of Licence

| Caravan Parks and Camping Grounds Act 1995, sec. 7(1)(a)<br>APPLICATION FOR GRANT<br>OR RENEWAL OF LICENCE |

| To | Local government: | | Facility name or proposed name | |

• Applicant/s[Each applicant to provide these details.] Family name:

| Land on which the facility is situated or is to be situated | Address:<br>or<br>Land description: |

• Land owner/s[1. Only necessary if applicant does not own the land referred to above.2. Details to be provided in respect of each land owner.] Family name:

• Declaration[Making a false statement may be an offence] I/We declare that all details in this form are true and correct.

• Signature of applicant/s: Date:

• Documents to be attached[Not necessary if application is for renewal of licence] 1. The written approval of the owner of the land referred to in this form for the applicant/s to make this application, or proof that the applicant/s is/are the owner/s of that land.

• 2. A plan of the proposed facility showing — (a) the sites, and where applicable, denoting the types of sites; (b) the buildings; (c) the roads and paths; (d) the drainage and waste water disposal systems; and (e) the location of fire hoses, fire hydrants and extinguishers.

• Only necessary for application for nature based park licence 3. A management plan containing details about these matters in relation to the facility: (a) market segment; (b) the amenities that are proposed to be provided, or not provided, at the facility; (c) site planning; (d) environmental impact and sustainability; (e) waste management; (f) traffic management; (g) risk management; (h) length of stay of occupiers.

[Form 1 amended: Gazette 12 Dec 2014 p. 4727.]

Form 2. Licence

| Caravan Parks and Camping Grounds Act 1995, sec. 7(4)<br>LICENCE |

| Expiry date | |

| Type of licence | |