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					City of                                                        Telephone:      03 5320 5562
                                                               Facsimile:      03 5333 4061
Ballarat                  PO Box 655
                                                               AUSDOC DX 35030
                          Ballarat Vic 3353
                          AUSTRALIA                            Ballarat  Victoria



                                  ARCHIVAL DOCUMENT SEARCH
                                                                                                                             Checked By
   Requestors Details:                                                                                                       C.S.O.

   Name                          ________________________________________________________

   Postal Address                ________________________________________________________

                                 ________________________________________________________

   Contact Phone No. ___________________                                        Facsimile No.____________________

   I, .............................................................................................................................. acting as
                                                      Owner or Agent of Owner
   It is an offence to act as an agent of the owner unless authorised in
                        writing by the owner to do so.

   request a search of the property known as:

   No.............               Street ................................................. Town ..........................................

   Lot No. ................ L/P No. ..........................................             P/S No. .......................................

   C/A No. ............... Section ..............                        Parish/Township ............................................


   I enclose a copy of Title for the above-described property.



   From former municipalities, we have archival information dating from:

   City of Ballarat – 1945                                           Shire of Buninyong - 1970
   Borough of Sebastopol – 1957                                      Shire of Grenville - 1970
   Shire of Ballarat – 1960                                          Shire of Bungaree – 1976




   Office Use Only:
   Receipt No. .......................            Date .......................        $88.00 (Non-refundable Search Fee)
                                                   Commercial/Industrial              $150 00 (Non-refundable Search Fee)
                                                                                      Rec: RC/PL
                                                                                                    #
   (Response Time –5 Working Days)                            Information to be collected:              Date/Time…………………


    #
        Files are held for 7 days only – additional search fee applies after
                                    this time.
                                                                    Basic Search
                                                                      Includes
                                                                                                           Yes                      No
                                             Building Permit

                                Certificate of Occupancy
                                             Or
                              Certificate of Final Inspections

                                                   Site Plan

                                                 Residential                                                    $88
                                               Commercial/Industrial                                            $150


                                             This is a Non-refundable Search Fee



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   Other information that may be available AT AN EXTRA CHARGE
                           Please indicate

                                                                                                                Yes                No
                                          Floor Plan


                             Architectural Drawings


                                           Soil Test




                                                          Paper Size                            Cost

                                                                 A0                             $7.00
                                                                 A1                             $6.00
                                                                 A2                             $5.00
                                                                 A3                             $1.00
                                                                 A4                             $0.50


Extra charges are calculated on a case by case basis

I understand that the search fee is non-refundable and that while every endeavour
will be made to locate the documents requested, no guarantees can be given.

SIGNED                                                                           DATED

				
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