Sch 2

SCHEDULE 2 Certificate of Registration of a Lodging House [clause 8.4] This is to certify that the premises situated at .......................................................................................... ........................................................................................................... are registered as Lodging House and classified as— a lodging house a short term hostel serviced apartments a recreational campsite other (specify) until 30 June 20............, on the following conditions—

1. that ………………………………………………………….., whose name is entered on the register of keepers of the Shire of Chittering, continues to be the keeper of the lodging house;

23 March 2017 GOVERNMENT GAZETTE, WA 1833 2. that …………………………………………………………….., appointed by the keeper to be the manager of the lodging house, continues to be the manager of the lodging house; 3. that the Certificate of Registration of a Lodging House is not sooner cancelled or revoked; That the maximum number of rooms to be used as sleeping apartments for lodgers is— 4. …………………; and 5. that the maximum number of lodgers accommodated on the premises shall not exceed……………………………… This Certificate of Registration of a Lodging House is issued subject to the Health (Miscellaneous Provisions) Act 1911 and the Shire of Chittering Health Local Law 2017 and is not transferable. Dated ....................................... 20................. Fee received: $.............................. ........................................................................ Signature Authorised Officer ————