Adjoining property owners details application

I, the adjoining owner# or agent* hereby request Council to provide the ownership details of the adjoining property for the following reason (please tick box below).

Dividing Fence - this information is requested to facilitate a fencing matter between my land and the adjoining land owner. It is requested under the Dividing Fences Act 1991. The property owner’s details will NOT be retained, copied or disseminated for unrelated purposes and will be kept secure and only used for advising and serving of fencing matters.Burning off - this information is requested to facilitate the notification of intention to burn off or burn firebreak to adjoining land owners/occupiers. It is requested under the Rural Fires Act 1997. The property owner’s details will NOT be retained, copied or disseminated for unrelated purposes and will be kept secure and only used for the notification of intention to burn off or burn firebreak.Tree - this information is requested to facilitate a tree matter between myself and the adjoining land owner. It is requested in order to satisfy Clause 49 (1)(b) of the Environmental Planning and Assessment (Regulation) Act 2000. The land owners details will NOT be retained, copied or disseminated for unrelated purposes and will be kept secure and only used for adjoining tree matters.Other

If other please specify

#An applicant must provide sufficient evidence of identity and place of residence (proof of ownership).

*An agent will be required to provide proof that they are authorised to act on behalf of the adjoining owner

Your name *

Mailing address

Street address

City

State

Postcode

Contact number *

Email address *

Property details

Property Address *

Street address *

City *

State *

Postcode *

Property number

Adjoining property details

NOTE: Council is not obliged to pass on the contact details of adjoining landowners for privacy reasons unless the request is made under the Dividing Fences Act 1991, the Environmental Planning and Assessment (Regulation) Act 2000 or the Rural Fires Act 1997. Only owner names and forwarding addresses will be provided. Personal contact details (i.e. email address or telephone numbers) of adjoining landowners will not be provided. Land titles details are also available from NSW Land and Property Information ( www.lpi.nsw.gov.au or 1300 052 637) for a prescribed fee.

Adjoining property address

Street address

City

State

Postcode

Proof of identity

Please provide at least one of the following as proof of your identity.

Australian driver’s licence

Browse

(with photograph, signature and current address)

Current Australian passport

Browse

Rates Notice

Browse

Proof of identity - agent

Letter of Consent from Owner

Browse

Power of Attorney

Browse

Guardian

Browse

Applicant declaration

Declaration *

I/we confirm that I am/we are the owner/s or agent for the owners of the property detailed and confirm that the adjoining property details requested will only be used for the purpose indicated.

Signature

Draw signature|Type signatureClear

Privacy Notification (Privacy and Personal Information Protection Act 1998 – Section 10) - Personal information collected in this application is considered personal or health information for the purposes of the Privacy and Personal Information Protection Act 1998 (PPIPA). Information provided will only be used for the purpose for which it is collected. The intended recipients of the personal information are Council officers and may extend to any person wishing to inspect the application in accordance with the Local Government Act 1993 or the Government Information (Public Access) Act 2009. The supply of this information is voluntary, however if you do not wish to provide all details requested, Council may be unable or limited in dealing with your request. You may make application to access, amend or suppress your personal information which Council will consider in accordance with the PPIPA.