REPORT ILLEGAL CAMPING

To report illegal camping please complete the online form or call 0427 491 399 / 0428 518 413.

Online Form - Application for Variation of Certificate of Approval

A confirmation message will appear once the form is submitted please retain this as evidence of submission.

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

Please tick the box below applicable to your application *

Permanent VariationTemporary VariationChange of Ownership

Have you received planning advice and approval?

YesNo

Building Approval Number *

Site Map/Building Plans

Please upload as much detail as possible including but not limited to exit widths, toilets, ventilation, structures, licensed area and available floor space (no hand drawn plans will be accepted)

Document 1

Document 2

Document 3

Details of Engineering for Structures

Electrical Compliance Form - All new installations need to be signed off using this form by electrician

Copy of Liquor License

Marquee Checklist

Additional Entertainment Details

Premise Details

Name *

Address *

Nearest cross street *

Reason for this variation from the Certificate of Approval *

Contact Details

Name of Owner/Agent

Address *

Phone/Mobile *

Fax

Declaration

In support of this application i tender the following details as required *

Date *

Declaration *

I declare that I am the person named as applicant on the above form and that the information contained in this application is true & correct in every particular

Get Audio Code

Type the code from the image

Welcome to the Shire of Exmouth

Online Form - Application for Variation of Certificate of Approval

General Office:

Address