New South Wales Consolidated Regulations

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PIPELINES REGULATION 2005 - SCHEDULE 3

SCHEDULE 3 – Forms

(Clause 3 (2))

Forms 1-13

Form 14 - Statement of intention regarding easements

(Clause 14)

Statement of intention regarding easements

( Pipelines Act 1967 )

Pursuant to the Pipelines Act 1967 , it is intended to acquire:

1 Easement
2 Easement

Form 15 - Instrument to accompany plan

(Clause 15)

Instrument to accompany plan

( Pipelines Act 1967 )

Plan No [number] (This is Sheet [sheet number] of a [number] Sheet Instrument)

Plan of pipeline from [date] to [date] containing [number] plan sheets as certified on [date]

Part 1
Full name and address of applicant for licence or variation of licence in whose favour all lands and easements over lands have been acquired or are intended to be acquired.

Part 2
Details of lands or easements over lands acquired or intended to be acquired. See Schedule to this Part.

Schedule
Land or easement (related to relevant Sheet No of within-mentioned Plan Reference to title and land description (including County and Parish) Name of owner *Details
(Registered No or description of any instrument referred to in Schedule 2 (10) (d) or (e) to Pipelines Regulation 2005 )
1
2
3
Etc

Part 3
Identities of easements referred to in abovementioned plan. (Grouped by categories as prescribed by Schedule 2 (7) to the Pipelines Regulation 2005 .)
1
2
3
Etc

Part 4
Terms of easements referred to in Part 3. (Set out the text of each easement as prescribed by Schedule 2 (8) to the Pipelines Regulation 2005 .)
1
2
3
Etc

Part 5
Details of lands to be excluded or easements to be extinguished. (See Schedule to this Part.)

Schedule
Land or Easement (related to relevant Sheet No of within-mentioned Plan) Reference to Title and Land Description (including County and Parish) Name of owner of subject lands *Details
(Registered No or Description of any instrument referred to in Schedule 2 (10) (d) or (e) to Pipelines Regulation 2005
1
2
3
Etc

[Signature of applicant]

* If applicant desires land to be vested in the applicant under section 21 of the Pipelines Act 1967 , insert “To be acquired under Pipelines Act”. If lands or easements are to be acquired by other means, those means must be specified.

Forms 16, 17

Form 18 - Easement for pipeline

(Schedule 2 (11) (a))

Easement for pipeline

( Pipelines Act 1967 )

Full and free right to the person in whose favour the easement is created, its successors and assigns, its and their servants and all persons authorised by it or them to act on its or their behalf at all times and from time to time:

(a) to lay, construct, repair, maintain, renew, use, operate and remove pipelines, apparatus or works for the conveyance of any substance whether in a gaseous liquid or solid state and for purposes incidental thereto under the Pipelines Act 1967 , through in and along the land herein indicated as the servient tenement, and
(b) to cause or permit to flow or be conveyed through and along the said pipelines any such substance, and
(c) with or without vehicles, plant and equipment to enter and be in the servient tenement for the purpose of exercising any rights granted to it or them hereunder, and
(d) to perform or carry out any act incidental to any of the aforesaid purposes.

Form 19 - Easement for access

(Schedule 2 (11) (b))

Easement for access

( Pipelines Act 1967 )

Full and free right for the person in whose favour the easement is created, its successors and assigns, its and their servants and all persons authorised by it or them to act on its or their behalf at all times and from time to time to go, pass and repass with or without vehicles, plant and equipment along over and upon the land herein indicated as the servient tenement for the purpose of access to any lands for constructing, using or operating any pipeline, apparatus or works under the provisions of the Pipelines Act 1967 including the inspection, maintenance, repair, reconstruction and removal of the same and for any other purpose connected with or incidental to any of the aforesaid purposes.



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