Legal Point of Discharge Request Form

Please note: this form requires a fee of $144.70. This fee can be paid by credit card over the phone after the application has been submitted. Additional fees may apply in particular circumstances. Cash and cheque payments can be made in person by visiting the Borough of Queenscliffe, 50 Learmonth Street, Queenscliff.

Applicant details
Land details
Proposal details

Describe the way the land is proposed to be used or developed.

Site plan/plan of subdivision

Note: A Stormwater 'Detention' / 'Retention' / Absorption System may be required for the proposed development.

Affirmation
  • I affirm that all details supplied in this application are true and correct to the best of my knowledge.
Privacy

Privacy Note: Council collects personal information to fulfil its statutory obligations, and to ensure that it can provide services to you. In some instances Council cannot provide some of its services unless you provide us with necessary information. Council will only use personal information for the purposes for which it was collected. Council staff are happy to discuss your privacy queries, however if you require further assistance you should contact our Privacy Officer on 5258 1377.