Sch 1

Schedule 1 APPLICATION FOR REGISTRATION OF A LODGING HOUSE (clause 8.1.3(a)) I/We ................................................................................................................................................................. of ...................................................................................................................................................................... .......................................................................................................................................................................... apply for the registration of premises situated (or to be situated) at .......................................................................................................................................................................... .......................................................................................................................................................................... as a lodging house to be classified as—

•  a lodging house;
•  a short term hostel;
•  serviced apartments;
•  a recreational campsite; or
•  other, (specify) ..............................................................................................................................
• ........................................................................................................................................................ and for my name to be entered in the Register as the keeper of the lodging house. DESCRIPTION OF LODGING HOUSE Number of storeys .......................................................................................................................................... Rooms for private use Number Area Laundries/toilets/bathrooms ................. ................... Bedrooms ................. ................... Dining Rooms ................. ................... Kitchens ................. ................... Sitting Areas ................. .................... Other (Specify) ................. ................... Rooms for lodgers Number Area Bedrooms ................. .................. Dining Rooms ................. .................. Kitchens ................. .................. Sitting Rooms ................. .................. Other (Specify) ................. .................. Sanitary Conveniences for male lodgers Toilets ................. Urinals ................. Baths ................. Showers ................. Hand Wash Basins ................. Sanitary Conveniences for female lodgers Toilets ................. Baths ................. Showers ................. Hand Wash Basins ................. Laundry Facilities Coppers ................. Wash troughs ................. Washing machines ................. Drying cabinets or ................. Clothes lines ................. Additional Details (a) Lodgers’ meals will be provided by the managers/ keepers/ lodgers. (b) The keeper will/ will not reside continuously on the premises.