Permit application

Sidewalk Cafes

Name of applicant:

Address:

Suburb:

Postcode:

Telephone:

Email:

Name:

Address:

Suburb:

Postcode:

No of tables:

No of chairs per table:

No of umbrellas:

Windbreak:

[ ] Yes [ ] No

No of outdoor heaters:

Planning permit approved:

[ ] Yes [ ] No

Tables constructed of:

Chairs constructed of:

Colour of tables:

Colour of chairs:

Colour of umbrellas:

Colour of windbreak:

•  Has an extension of a Liquor Licence been approved

[ ] Yes [ ] No

•  To assist processing the application I have attached a copy of a sketch plan, or photograph, of the sidewalk café I propose to establish

[ ] Yes [ ] No

•  I have attached a current copy of my public liability insurance to the value of $10,000,000 valid for the period of the permit and endorsed to cover the sidewalk café at the location specified

[ ] Yes [ ] No

•  I have also attached written indemnification of Council against any liability for any activities that may be authorised by the permit if issued by Council

[ ] Yes [ ] No

•  This is a new permit application

[ ] Yes [ ] No

•  This is a renewal of an existing permit

[ ] Yes [ ] No

•  I have enclosed the an application fee of $85.50

[ ] Yes [ ] No

•  This is an amendment to an existing permit

[ ] Yes [ ] No

Signature of applicant:

Date:

Personal information collected on this form is to assist Council staff to process and assess an application required by General Local Law 2018 and will be used solely for that purpose. Personal information will not be disclosed to any other person unless required by law. You may apply for access and/or amendment to your personal information by contacting Council’s City Compliance Department.

Application Fee
Cost code: GL 961

Permit Fee
Cost code: GL 962