Works On Waterways Application Form

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Works on Waterways Application Form

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Application for a Permit is required by Corangamite Catchment Management Authority pursuant to By-law No. 4 Waterways Protection 2014 of the Water Act, 1989.

The applicant must complete all details on this form, attach all required details, and ensure that the indemnity clause is signed. Before completing this application, please ensure you read the Guidelines for Applying for a Works on Waterways Permit and the specific notes for the proposed work type that you wish to undertake. Please also review the Works On Waterways Permit Terms And Conditions and if required read the explanatory information on Stormwater Outlets.

1. NAME OF APPLICANT (May be a person representing the owner.)

Name(Required)

First Last

Company Name (if applicable)

Email(Required)

Postal Address (including postcode)(Required)

Phone (daytime)(Required)

Mobile Phone

Is the applicant also the owner of the land?(Required)

Yes

3. NAME OF WATERWAY DETAILS

Name of Waterway (if known)(Required)

Tributary of

4. PROPERTY DESCRIPTION WHERE THE WORKS ARE PROPOSED

Property Address(Required)

(e.g. 3 Kurrajong Road, Homesview)

Please include if known:

Crown Allotment and Parish Name

e.g. Lot 4 of PS144333

Lot Number of Plan of Subdivision (PS) or Lodge Plan Number (LP), etc.

e.g. Lot 4 of PS144333

Are the works on Crown Land or Private Land?(Required)

Crown Land

Private Land

If the works are on Crown Land, it is the responsibility of the applicant to contact the Department of Environment, Land, Water and Planning to obtain landowner consent.

Any further useful details to help us determine the location

Have you had a pre-application meeting or contact with a CMA staff member?

Yes

If yes, who with?

5. GENERAL DESCRIPTION OF THE PROPOSED WORKS

Please Tick All That Apply

Bridge

Culvert

Ford

Storm Water

5A. GENERAL DESCRIPTION OF THE PROPOSED WORKS

Describe the land use(Required)

(e.g. grazing, cropping, residential, etc.) adjacent to the proposed works site

Proposed Use/Purpose of Works(Required)

Please give a detailed description of the works(Required)

5B. WATERWAY DIMENSIONS (in metres)

Distance between top of waterway banks

Distance across waterway bed

Depth from top of bank to bed

5C. Describe any erosion and vegetation details

Is there evidence of erosion in the bed and banks of the waterway?(Required)

Yes

Describe the type and extent of existing vegetation on the bed and banks of the waterway at the proposed site.

Bed

Banks

5D. Describe the soil type of the bed and banks

BED of the waterway:

Please tick the appropriate box

Clay

Loam

Sand

Gravel

Rock

Other

Other bed soil type(s):

BANKS of the waterway:

Please tick the appropriate box

Clay

Loam

Sand

Gravel

Rock

Other

Other bank soil type(s):

6. Crossing/outlet details

You did not select Crossing - Bridge, Culvert or Ford, or Stormwater Outlet in section 5 above, no further details are required.

Bridge Crossing Proposed Bridge Dimensions:

Bridge - Width in metres

Bridge - Total length in metres

Bridge - Height of soffit above bed in metres

Bridge - Number of spans

Bridge - Proposed Material

Concrete

Steel

Timber

Bridge - Other proposed crossing material

Pipe and Box Culvert CrossingProposed Culvert Dimensions:

Culvert - Size of box or pipe diameter in metres

Culvert - Width of crossing in metres

(measurement from upstream to downstream)

Culvert - Length of crossing in metres

(measured from bank to bank)

Culvert Type

Box Culvert

Pipe Culvert

Culvert - Number of parallel culverts

Culvert - Height of crossing above waterway bed level in metres

Culvert endwall material and style

Culvert - Proposed material of culvert pipe/box

Concrete

Steel

Culvert other proposed material

Ford - Total Width of ford crossing in metres

(measured from upstream to downstream)

Ford - Total Length of ford crossing in metres

(measured from bank to bank)

Stormwater Outlet - Stormwater catchment area

(in metres)

Stormwater Outlet - Expected increase in peak flowrate

(in metres)

Stormwater Outlet - Expected velocity at outlet

(in metres per second)

Stormwater Outlet - Are treatment/detention/retention measures in place?

Yes

If yes, please describe

7. ANCILLARY WORKS

Do the proposed works involve stream-realignment(Required)

Yes

Are there any proposed bed and/or bank protection works?(Required)

Yes

Please provide detail of the bed/bank protection works

8. NATIVE VEGETATION REMOVAL ASSOCIATED WITH THE PROPOSAL

Will any native vegetation be removed?

Yes

(includes trees, shrubs, grasses)

If YES, please specify the type and amount/area of vegetation to be removed

You should contact your Local Council to determine whether a planning permit is required

Have you considered alternative work sites to minimise native vegetation removal?

Yes

If NO, please explain reason

9. UPLOAD PLANS, DRAWING and SUPPORTING DOCUMENTS

Property map showing where the works will be specifically (i.e. more zoomed in than locality map)

Photos of waterway at works location looking upstream and downstream.

Photos of works location showing both banks

Detailed sketch/engineering plans of works showing all dimensions, sizes and materials to be used

Any other relevant material

Upload your supportig documents

Drop files here or

Accepted file types: jpg, jpeg, png, gif, pdf, Max. file size: 35 MB, Max. files: 10.

11. INDEMNITY CLAUSE

Consent(Required)

I agree to the INDEMNITY CLAUSE below

I acknowledge that the Corangamite Catchment Management Authority may issue a permit for the construction of the works on a waterway but that Corangamite Catchment Management Authority shall not be responsible for any claims, suits or actions, arising from injury, loss, damage or death, to any person or property which may arise from the construction, maintenance, existence or use of the works.

I hereby indemnify the Corangamite Catchment Management Authority and its officers against all claims, suits or actions arising from injury, loss, damage or death, to any person or property which may arise from the construction, maintenance, existence or use of the works described in this application.

Type your Name(Required)

Please indicate your preferred method of correspondence(Required)

Mail

Please allow up to 28 days for application processing. Missing or incomplete information may delay this process further.