New South Wales Consolidated Regulations New South Wales Consolidated Regulations(Clause 4)
APPLICATION FOR A BORE LICENCE UNDER PART 5 OF THE
(Section 113,)
SECTION 1
Applicant(s):
Surname:First Names:
Surname:First Names:
Postal Address:
Post Code:Telephone:
Property Address:
Post Code:Telephone:
| Location of work to be licensed | Portion/Lot/DP | Parish | County | ||
| Nature of work to be licensed | □ Proposed | □ Alteration | Proposed depth in metres | □ Existing | |
| Is work to replace an abandoned work? | Is work to be altered already licensed? | Is application replacing an existing licence? | |||
| □ Yes □ No | □ Yes □ No | □ Yes □ No | |||
| Details | |||||
| Type of work | □ Bore | □ Well | □ Excavation | ||
| □ Spearpoints(s) | □ Artesian bore | □ Test bore | |||
| Ultimate purpose for which water is to be used from the completed or converted work | □ Stock | □ Waste disposal | □ Irrigation | □ Sand and gravel washing | Estimated annual usage in megalitres |
| □ Domestic | □ Town water | ||||
| □ Farming (Not irrigation) | □ Drainage | □ Recreation | □ Industrial/ commercial | ||
| □ Mining | |||||
| If application purpose is for town water, please provide in a separate sheet details of ALL existing town water bores and wells including: Bore No., Licence No., annual allocation and usage in megalitres. | |||||
| Complete if other landholders to be supplied with water | Name | Portion/ Lot/DP | Parish | County | Purpose of supply |
SECTION 2 (complete this section if the application includes irrigation)
| Description of property (from your rate notice or local Council) | Portion/ Lot/DP | Parish | County | Total area in hectares | Is the property leased? |
| □ Yes □ No | |||||
| Details of crops to be irrigated | □ Orchard | □ Vines | □ Other | Area in hectares | |
| Any other irrigation from bores and wells | Number of bores and wells | Type of crop(s) | Area in hectares | ||
| Any other irrigation | From rivers, lakes etc | Area authorised | From Ministerial Corporation channels | Area authorised | |
| □ Yes □ No | □ Yes □ No | ||||
| Details |
I/We apply for a licence to construct and use the works described above and to use the water obtained only for the purpose specified in the application.
Attached are:
1. PLANS showing:(a) the boundaries of the land occupied by me/us;(b) the site of the bore to be licensed;(c) the boundaries of any land to be irrigated;(d) the boundaries of the land of any other person to be supplied with water from the proposed works.
2. The prescribed FEE of $.
Dated thisday of19.
Signature/s of applicant/s
Water Administration Ministerial Corporation.
(Clause 5)
BORE LICENCE
(Section 115,)
Date IssuedNo.
Name and address of Licensee:
LOCATION OF LICENSED BORE
Portion/Lot/DP:
Parish:
County:
Nature and description of bore:
Purposes for which water may be used:
LOCATION OF LAND TO BE IRRIGATED
Portion/Lot/DP:
Parish:
County:
| Area to be Irrigated: | hectares | Period for which licence is issued: | years |
| Volume of water which may be taken annually: | megalitres |
The bore described above and referred to in the application and plans deposited by the licensee is declared to be a licensed bore under the Water Act 1912 .
This licence is subject to the terms, limitations and conditions, if any, set out in the attached statement.