Swimming Pool Barrier Compliance Certificate Application Full Postal Address: Contact Telephone Number: Business Telephone Number: Applicant Name: Email Address: Lot Number: DP Number: Property Address: Is the Property for sale: Yes No Is the Property for lease: Yes No Is the pool registered in NSW Swimming Pools Register: Yes No (REGISTER NOW) Name: Contact Number: Access Instructions (if any): Type of Property: Area less than 230m 2 Other Type of Pool: Above Ground/Inflatable Outdoor In Ground Spa/Hot Tub Indoor Year of Pool Construction/Alteration: Pre 1 August 1990 1 August 1990 - 31 August 2008 1 September 2008 - 31 March 2013 After 31 March 2013 Does the pool come under any of the following categories:Visitor or Tourist Accommodation, Hotel, Motel, Backpackers, Bed & BreakfastPool used by more than 2 dwellings, sole occupancies, apartmentsServiced apartment or short term rental accommodation Checkbox List Yes No Owner(s) Name: Address: Contact Telephone Number: Business Telephone Number: Email Address: As owner(s)/owner's authorised agent of the land to which this application relates, I/We consent to this application. I/We also consent for authorised Council Officers to enter the land to carry out inspections and take any photographs of the pool area. Owner's Signature(s): Type It Draw It Clear Print your name Please type your signature Please sign here Agent's Signature(s): Type It Draw It Clear Print your name Please type your signature Please sign here An Application Fee of $250 is payable at the time of lodging the initial application.If only one inspection is required a refund of $100 will be returned to you.Council will not process an application where the applicable fee has not been paid. Application Type: Initial Application Reinspection Application Reference: Date Received: Application Fee: $250 Receipt Number: Previous Council Approval Obtained: Yes No Council Approval Details DA Number: Building Certificate Number: NSW Registration Number: