Application to Pile Burn

Protection of the Environment Operations (Clean Air) Regulation 2010

Application Form

Applicant Details

First Name

Last Name

Address

Phone

Application Details

Location Address of Bush Fire Hazard Reduction Works

What existing assets will this proposed activity be protecting?

A house

Other buildings (eg: machinery and hay sheds)

Crops, pasture or fence

Other

Pile burn consists of:

Dead vegetation only – naturally fallen

Dead vegetation only – mechanically cleared

Other

Maximum size of pile to be burnt

Reason for burning of pile

Proposed Start Date

Proposed End Date

How was the area last treated for hazard reduction?

Hazard reduction

Mowing / slashing

Ploughing

Grading

Wildfire

Unknown

Not treated

What is the vegetation type?

Forest

Shrubs

Grass

Not native

Or what is the vegetation formation (if known)

Provide details of any known threatened species, population or ecological community

Provide details of any known Aboriginal relic or place

Authorisation

As the owner / occupier of this land I consent to the above bush fire hazard reduction works and attest that the information on this form is correct and to the best of my knowledge

Privacy Policy

By completing this form you are enabling Wollondilly Shire Council to collect personal information about you for the purpose of assistin the determination process of your application. This information is required by law and failure to provide the information ma g in y lead to rejection or delays of your application. At any time you have the right to access, view or correct the personal inf ormation that you have provided. The information will be stored in Council's records system and may be placed on Council’s Website or be subject to access information under the Government Information (Public Access) Act 2009 (GIPAA).