Public Place Activity

Public Place Activity - permit application

Applicant details

Who is applying for the permit? *

Individual/sIncorporated Association / Corporation

Individual 1 full name *

Phone number *

Email Address *

Postal address *

Are there any other persons to be named on the permit? *

YesNo

Individual 2 full name *

Phone number *

Email Address *

Postal address *

Entity name *

ACN

Postal address *

Registered address of corporation or organisation

Email Address *

Phone number *

Nominated contact person's full name *If the applicant is a corporation or organisation, a contact person must be nominated for the permit and must be duly authorised to act on behalf of the corporation.

Contact person's position held (eg Director, Company Secretary etc) *

Phone number of contact person *

Email address of contact person *

Activity details

What activity are you applying for?

Fundraising: eg street stall, bake sale, sausage sizzle to raise funds for a charity or other not for profit cause etcA display, demonstration, educational or informational activity: eg an educational booth to raise awareness for an environmental issue which does not involve any commercial benefit.A research or scientific investigation activity: eg exclusive use of Council controlled area to undertake research into a species of frogs

Location and details

Provide a description of the activity including the purpose and how the activity will be carried out. *

What is the proposed location of the activity? *

What are the hours you propose to use the area? *

What are the overall dimensions and total area proposed to be used? *

Do you propose to use any furniture and/or structures? *

Do you propose to sell food or beverages to the public? *

YesNo

Please provide details of the food and beverages to be sold, who is to prepare the food or beverages and where and whether there are any food licences in place. *

Are there any advertising devices proposed to be installed in the Permit area? *

YesNo

Any advertising devices must comply with Council’s Local Law No. 4 (Advertising Devices) 2019. Depending on the location and type of advertising device, you may require an additional permit, be required to comply with certain requirements or the advertising device might be prohibited.

What type of signs will be installed in the Permit area? *

How many signs will be installed in the Permit area? *

Please provide any further information if applicable

Supporting documents

Please provide copies of each of the following documentation with your application. If any of the following are not included with your application, your application will be considered incomplete and Council will not be able to commence assessing your application.

A site plan is required to be submitted for all permit applications. Site plans can be hand drawn or electronic, but must be an aerial view with measurements and must include the following:

the overall area being applied for which shows the outline of adjoining buildings
the location of all furniture, structures, advertising devices and other items intended to be placed in the area
the location of any permanent infrastructure within the area or immediately adjoining it – this includes but not limited to trees, fire hydrants, transformers, telephone booths, mailboxes, bus shelters, rubbish bins, pillars and posts (awning or building supports) and any other permanent items
measurements on the site plan for the overall length and width of the area.Site plans can be hand drawn or electronic.

Site Plan *

Browse

A certificate of currency for Public Liability Insurance held in the name of the Permit Holder for an amount of no less than $20 million which notes the Cairns Regional Council as an interested party. *

Browse

Evidence of any other approvals that may be required in relation to the activity

Browse

Declaration

If the application is made by a corporation or incorporated association, the person signing the form must occupy a position that is legally entitled to make an application on behalf of the corporation or incorporated association.

I declare that the information provided in this application form and any other documentation submitted in connection with this application is true and correct and consent to Cairns Regional Council making enquiries and exchanging information with authorities of any Local, State/Territory or Commonwealth department regarding any matters relevant to this application.

*

I agree that in the event that a permit is issued following assessment of this application form, that I will keep in effect during the term of any permit issued, a certificate of currency for public liability insurance which notes Cairns Regional Council as an interested party and which is to be for a value which is not less than $20 million and which is held in the name of the permit holder.

*

I indemnify Cairns Regional Council, including its employees, representatives or agents, from and against any action, claim, demand, loss, damage, cost and/or expense that is or may be suffered by Cairns Regional Council in connection with or related to the assessment of this application.

*

In the event that this application is approved, I also indemnify Cairns Regional Council, including its employees, representatives and agents, from and against any action, claim, demand, loss, damage, cost and/or expense that is or may be suffered by Cairns Regional Council in connection with or related to the activity and/or the use of the Council controlled area or road in any way.

*

I have read and understood the above declaration and confirm that the information provided in this application and any supporting documents are true and correct.

*

Information Privacy statement

Your personal information has been collected by Cairns Regional Council for the purpose of assessing your permit application . The collection of your information is authorised under the Local Government Act 2009. You are providing personal information which will be used for the purpose of delivering services and carrying out Council business. Your personal information is handledin accordance with the Information Privacy Act 2009 and will be accessed by persons who have been authorised to do so. Your information will not be given to any other personor agency unless you have given Council permission to or the disclosure is required by law.

Electronic communications statement

In accordance with the Electronic Transactions (Queensland) Act 2001, Cairns Regional Council consents to the information provided in this application by the applicant to be provided by way of electronic communication. Additionally, Cairns Regional Council may provide to you notices, such as an information request or permit, by way of electronic communication. Your consent to this form of electronic communication is taken to be given to Cairns Regional Council by completing this application and submitting this electronic form.