LUM Application form by monkey6

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									DEPARTMENT : TOWN PLANNING

LAND USE MANAGEMENT APPLICATION
Local district planning office contact numbers District A B C D Office location Cape Town CBD Milnerton Kraaifontein Parow Area covered Camps Bay - Pinelands Mamre - Ysterplaat Durbanville - Kraaifontein Goodwood - Bellville Ph no District 400 5352 E 550 1090 F 980 6265 G 590 1416 H Office location Area covered Kuilsrivier - Gordon's Bay Somerset West Khayelitsha - Mitchell's Plain Khayelitsha Philippi - Grassy Park Plumstead Rondebosch - Simon'sTown Plumstead Ph no 850 4346 360 1101 710 9374 710 8203

Please complete this form using block capitals and ticking the appropriate boxes. Application number (To be completed by an official)

SECTION A : APPLICANT / AGENT DETAILS
First names Surname Company name Business address VAT no

Postal code Tel

E-mail Fax Cell

SECTION B : PROPERTY DETAILS
Erf / Erven / Farm no Street address Suburb Relevant Zoning scheme Current zoning Approximate age of existing buildings Any restrictive title deed conditions? Is property encumbered by a bond? Y Y N N If Yes, please specify If Yes, bondholder? Extent Title deed no T Title deed date Y Y Y Y M / M m² / ha Y D Y D Allotment area

SECTION C : OWNER DETAILS (if different from applicant)
Registered owner Business address

Postal code Tel

E-Mail Fax Cell

SECTION D : TYPE OF APPLICATION BEING SUBMITTED
Has there been any previous related application? Y N If Yes, reference / application no

FEES PAID

Rezoning - Section 17(1) of Ordinance 15 of 1985 or Regulation 5(1) of PN 733/1989 in terms of Act 4 of 1984 Special consent / Conditional use - Section (please specify) Temporary land use departure - Section 15(1)(a)(ii) of Ordinance 15 of 1985 Regulation departure - Section 15(1)(a)(i) of Ordinance 15 of 1985 or Regulation 7(1) of PN 733/1989 in terms of Act 4 of 1984 * Removal / suspension / amendment of Title deed restrictions - Section 3(1) of Removal of Restrictions Act 84 of 1967 Subdivision - Section 24(1) of Ordinance 15 of 1985 or Regulation 17(1) or 19(5) of GN R1897/1986 in terms of Act 4 of 1984 Subdivision exemption - Section 23(1) of Ordinance 15 of 1985 of Zoning scheme regulations

R R R R R R R

Amendment / cancellation of Plan of Subdivision - Section 30(1) of Ord 15/85 or Regulation 17(1) or 19(5) of GN R1897/86 ito Act 4/84 R Subdivision of agricultural land - Section 4(1)(a)(i) of Subdivision of Agricultural Land Act 70 of 1970 Amendment / deletion of conditions of approval / schedule conditions - Section 9(2) or 42(3)(a) of Ordinance 15 of 1985 Extension of validity period of LUPO approval - Section 15(5) or 27(1) of Ordinance 15 of 1985 Approval / amendment of Site development plan - Section 42(1) or 42(3)(a) of Ordinance 15 of 1985 Township (or less formal township) establishment - Act 4 of 1984 or Act 113 of 1991 Application in terms of any other legislation (please specify) If required, has application for EIA / HIA / TIA / TIS / MHIA approval been made? Y * Note : In case of a Removal of restrictions application, there is also a separate additional application form to be filled out, which form is also available at your local planning office.
THIS CITY WORKS FOR YOU ESI SIXEKO SISEBENZELA WENA
LUM APPLICATION FORM Version 2006/10/25

R R R R R R N Complexity fee R

Advertising / notification fee R TOTAL Application fee R
HIERDIE STAD WERK VIR JOU

Brief description of proposed development / intent of application (incl condition(s) / SDP amendments required)

SECTION E : LIST OF ATTACHMENTS & SUPPORTING INFORMATION REQUIRED / SUBMITTED
Y Y Y Y Y Y Y Y Y Y Y Y Y N N N N N N N N N N N N N Power of attorney Bondholder's consent Copy of Title deed Conveyancer's certificate List of Title deed conditions to be removed / amended Motivation report / letter Locality plan SG noting sheet extract / Erf diagram / General plan Proposed Plan of Subdivision Electronic copy of Plan of Subdivision Site layout / Sketch plan (& elevations) illustrating proposal (A4 or A3) Site development plan Landscaping plan Y Y Y Y Y Y Y Y Y Y Y Y Y N N N N N N N N N N N N N Copy of EIA / HIA / TIA / TIS / MHIA or RoD Indication of all municipal services / registered servitudes Services report Phasing plan Contour plan Floodline certificate Typical unit types (plan & elevation) Abutting owner's consent Home Owners' Association consent / stamp of approval Application fee / receipt Required no of documentation copies Other (please specify ) copies

SECTION F : DECLARATION
Note : If application made by person other than owner, power of attorney must be submitted. If property owned by more than one person, signature of each owner to be obtained. Where owned by company / trust / other juristic person, certified copy of board of directors / trustees resolution required.

I hereby certify the information supplied in this application form to be complete and correct and that I am properly authorised to make this application.

Applicant's / Owner's signature

Date

Y

Y

Y

Y

M

M

D

D

Full name Professional capacity Applicant's ref

Development contribution I hereby certify that I've had discussions with the relevant local district engineer, who informed me of the development contributions payable in respect of the development proposed herein.

Owner's signature

Date

Y

Y

Y

Y

M

M

D

D

FOR OFFICE USE ONLY

Date received Receipt no

Y

Y

Y

Y

M

M

D

D

Received by File ref

THIS CITY WORKS FOR YOU

ESI SIXEKO SISEBENZELA WENA

HIERDIE STAD WERK VIR JOU

LUM APPLICATION FORM Version 2006/10/25

SECTION D : TYPE & DETAIL OF APPLICATION BEING SUBMITTED (continued)
Departure / consent / amendment required Street Street Side Y N Building line encroachment Side Aggregate side Rear Y Y Y Y Y Y Y Y Y Y Y N N N N N N N N N N N Exceeding permissible site coverage Exceeding maximum permitted bulk / floor factor / no of habitable rooms Exceeding height restriction / permissible no of storeys Exceeding maximum storey height Exceeding maximum boundary wall height Relaxation of on-site parking / loading requirements Erection of 2 / additional dwelling unit Erection of double dwelling Erection of special / accessory buildings (please specify ) Work in an Urban Conservation Area (please specify ) Other (please specify )
nd

From From From From From From From From From From Street From m To m Side / rear From From

m m m m m m %

To To To To To To To To

m m m m m m %

m/st To m m To To

m/st m m bays m² m² m²

bays To Extent Extent Extent

Additional description of departures / consents / amendments required (if necessary)

THIS CITY WORKS FOR YOU

ESI SIXEKO SISEBENZELA WENA

HIERDIE STAD WERK VIR JOU

LUM APPLICATION FORM Version 2006/10/25

FOR OFFICE USE ONLY (continued)
Assessment checklist (iro Regulation departures / SDP amendments, where no objections) Does proposal comply with all setback requirements? Were abutting owners notified & their comments / consent obtained? Were any objections received against the application? Would any services / infrastructure be adversely affected? Is vehicular access to and parking on the premises still possible? Would vehicular sight lines / visibility be adversely affected? Have road widening schemes / Div road b/lines been taken intoaccount? Y Y Y Y Y Y Y N N N N N N N N/a Is PRE approval required & has it been obtained? N/a Would proposal adversely affect any conservation area? N/a Would proposal detract from UCA's architectural character? N/a Is site subject to any scenic drive restrictions? N/a Would an undesirable precedent be set? Y Y Y Y Y N N N N N N N N/a N/a N/a N/a N/a N/a N/a

N/a Does proposal comply with township est. / subdiv. conditions? Y N/a Are there any title restrictions / conditions? Y

Application description (where approval different from Section D, ie in case of partial approval)

Decision In terms of Section 15(1)(b) and/or 42(3)(a) of the Land Use Planning Ordinance (Ordinance 15 of 1985) or Regulation 7(4) of PN 733/1989 in terms of Act 4 of 1984 and/or Section _________ of the _______________________________ Zoning scheme regulations (delete incorrect option) and delegated powers of authority, the above application is hereby Approved Refused in accordance with the attached Plan no and

subject to the following conditions (if any) : Conditions of approval (if any)

Reasons for decision

Delegated official's signature Official's name (in block capitals) for Director : Town Planning

Date

Y

Y

Y

Y

M

M

D

D

THIS CITY WORKS FOR YOU

ESI SIXEKO SISEBENZELA WENA

HIERDIE STAD WERK VIR JOU

LUM APPLICATION FORM Version 2006/10/25


								
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