If you have any questions or concerns with the application process please contact Shire of Exmouth Environmental Health Services on 9949 3000.

Section A

Applicant Details

Land Owner/s Details

1. Only necessary if applicant does not own the land referred to above.
2. Details to be provided in respect of each land owner.

Section B

Quantity of Sites

Section C

Facility Details

Female Facilities 

Male Facilities 

Disabled Facilities 

Laundry Facilities 

Kitchen Facilities 

Section D

Additional Documentation 

Following not necessary if application of for a renewal of licence 

Please provide a plan of the proposed facility including:

• Sites and type
• Buildings
• Roads and paths
• Drainage and waste water disposal systems 
• Location of fire hoses, hydrants or extinguishers  

Please provide a management plan containing details about these matters in relation to the facility:

1. Market segment
2. The amenities that are proposed to be provided, or not provided at the facility
3. Site planning
4. Environmental impact and sustainability
5. Waste management
6. Traffic management
7. Risk management
8. Length of stay of occupiers

Declaration