Significant Natural Features application form

Applicant's details

Name of applicant or community group:*
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Contact person:*
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Postal address:*
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Daytime phone:
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Email:*
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Name and contact details of landowner (if different from above):
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If you are not the landowner, please attach confirmation that you have landowner’s approval for the project.
Your file must be under 2MB Maximum file size is 2MB
Are you registered for GST?
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Project Property Details

Physical location/address of project:
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Assessment Number (from rates demand notice):
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Project Details

What type of significant natural area is the project for?*



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If 'other', please specify
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Approximately how large is the significant site on your property?
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Please attach a site map detailing where the Significant Natural Feature is located on your property.
Your file must be under 2MB Maximum file size is 2MB
Are you currently doing anything to preserve and protect the significant site (eg. pest control, stock excluded through fencing etc)?
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Is this site currently legally protected? (e.g. QEII open space covenant, district plan, conservation covenant etc)
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If yes, please provide a copy of the protection document*
Your file must be under 2MB Maximum file size is 2MB
Maximum file size is 2MB
If the site is not legally protected and your application is successful, do you intend to: (Note: Your site must be legally protected in perpetuity before funding will be released.)*
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Do you have any long term plans for this project?
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If yes please provide details:
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Please give a full description of your project that will preserve/protect the Significant Natural Feature. Include the objective and anticipated outcomes of the project, what has already been done, what you want done, a site plan showing the area(s) of concern, pre-project photographs, current and anticipated problems or threats to the area, what resources are required, how it fits in with the criteria, and any other information and supporting documentation that may help with your application. If your project involves constructing new fencing please also describe the topography*
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Attach additional pages if necessary
Your file must be under 2MB Maximum file size is 2MB
When are you expecting to commence your project?*
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When are you expecting to complete your project?*
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Financial details

Please provide details on the costs of the project (excluding GST), itemising and providing a quote where appropriate. Include self labour (hours involved) or contracted labour (costs involved). Note: If your application is successful, Council will fund up to 50% of the projects total cost.*
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Attach files if necessary.
Your file must be under 2MBMaximum file size is 2MB
Total cost of project:*
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Please indicate any other funding you have obtained for the project
Donated materials:
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Cash in hand for the project
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Fundraising (estimate):
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Other:
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Other funding agencies:
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Total funds obtained:*
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Declaration
I hereby declare that the information supplied here is correct. If the application is successful, I agree to participate in any auditing of my project conducted by the local authority. I consent to the Matamata-Piako District Council collecting the personal contact details provided above. I undertake that I have obtained the consent of the contact person to provide these details and we acknowledge our right to have access to this information. The consent is given in accordance with the Privacy Act 1993.
Name:*
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Please tick the box:*
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