Supplementary to Form 1
Plumbing & Drainage
Planning and Environment
Engineering and Environmental Assessment
City Development
PO Box 5042 GOLD COAST MC QLD 9729
P 07 5582 8393 F 07 5596 3653
E [email protected]
W cityofgoldcoast.com.au
To assist in the timely assessment of your Plumbing & Drainage application, please complete the following fee
calculation worksheet and information checklist.
Fees
These fees are in accordance with Council’s regulatory fees and non-regulatory charges. A copy of Council’s
regulatory fees and non-regulatory charges can be found on the website.
Application Type
Residential sewered?
If “Yes”, go to Section 1
Residential unsewered?
If “Yes”, go to Section 2
Commercial sewered?
If “Yes”, go to Section 3
Commercial unsewered?
If “Yes”, go to Section 4
Section 1: Class 1 & 10 Residential application (sewered)
Is this an amendment to an existing approval?
$124.00 application fee
$103.00 per additional
fixture
Yes
No
Previously approved BLD number
Is this a new application?
Number of fixtures?
Yes
Assessment of one to four (1- 4) fixtures
$456.00 total minimum fee
No
Assessment of five (5) or more fixtures
$103.00 per fixture
Is a testable backflow prevention device
associated with this application?
Yes
$103.00 per device
No
Does this application include a rainwater tank
which is connected to plumbing fixtures in a water
reticulated area?
Yes
$122.00
No
Sub total $
Information checklist
Please advise that you have submitted the following forms and/or information with your application.
 Form 1 compliance assessment
Yes
No
 1x floor plan
Yes
No
 1 x site plan
Yes
No
 Supplementary to Form 1
Yes
No
Yes
No
Does the application require a new water meter?
If “Yes”, please refer to City of Gold Coast’s water and sewerage webpage for
more information on lodging an application for a water meter.
Office use only
Date received
Fee paid
Received by
Receipt number
Business partner name
Account number
Business partner number
AMS code
Document #17239318 v51
Last updated 31/01/2017
(if applicable)
Page 1 of 4
Supplementary to Form 1 Plumbing & Drainage
Section 2: Class 1 & 10 Residential application (unsewered, on-site sewerage facility)
Is this an amendment to an existing approval?
Yes
$124.00 application fee
$103.00 per additional fixture
No
Yes
No
Previously approved BLD number
Is this a new application?
Is this an on-site sewerage facility including
fixtures?
Yes
$491.00 application fee
$103.00 per fixture
No
Is this a conversion from septic to treatment
plant?
Yes
$704.00
No
Is this an on-site sewerage facility concurrence
fee application?
Yes
$357.00
No
Is installation of land application area only?
Yes
$213.00
No
Sub total $
Information checklist
Please advise that you have submitted the following forms and/or information with your application.
 2 x copies of a site and soil report for the on-site sewerage facility
proposal
Yes
No
 2 x scaled site plans showing the location of the proposed or existing
on-site sewerage facility, the land application area and all existing
structures on the property
Yes
No
 the distance from the land application area to the boundary of the
property
Yes
No
 the distance from the land application area to all impervious surfaces on
the premises, i.e. concrete paths and paved areas
Yes
No
 the distance from the land application area to any bodies of water that
may be affected by the effluent from the proposed on-site sewerage
facility
Yes
No
Section 3: Class 2 – 9 Commercial application (sewered)
including Commercial Class 10, housing developments and civil services
Is this an amendment to an existing approval?
Yes
$456.00 application fee
$103.00 per additional fixture
No
Yes
No
Previously approved BLD number
Is this a new application?
Is the commercial activity major or minor?
Major
$1042.00
Minor
Number of fixtures up to thirty
(30) floors in height
$456.00
$103.00
per fixture
Number of floors in height?
Number of fixtures over thirty
(30) floors in height
$49.00 per
fixture
Is a testable backflow prevention device
associated with this application?
Yes
$103.00 per device
No
Does this application include fire sprinkler
installation?
Yes
Number of floors x $167.00
per floor
No
Does this application include a rainwater tank
which is connected to plumbing fixtures in a water
reticulated area?
Yes
$122.00
No
Document #17239318 v51
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Supplementary to Form 1 Plumbing & Drainage
Does this application include an Automatic Meter
Reader (AMR)?
Yes
$369.00 minimum fee for 50meters or less, plus $70.00
per 10-meters or part thereof
No
Does this application include a water sub-meter?
Yes
$233.00 minimum fee for 50meters or less, plus $46.00
per 10-meters or part thereof
No
Does this application include water mains 100millimetres and above?
Yes
$8.00 per metre
No
Does this application include sewer mains 150millimetres and above?
Yes
$8.00 per metre
No
Does this include civil sewer access chambers?
Yes
$154.00 per chamber
No
Does the application include fire hydrants?
Yes
$49.00 per fire hydrant
No
Applications that relate to civil works only
Sub total $
Information checklist
Please advise that you have submitted the following forms and/or information with your application.
 Form 1 compliance assessment
Yes
No
 3 x hydraulic drawings
Yes
No
 1 x floor plan
Yes
No
 1 x site plan
Yes
No
 1 x architectural drawing
Yes
No
 3 x civil hydraulic drawings
Yes
No
 3 x stormwater drawings
Yes
No
 Supplementary to Form 1
Yes
No
 3 x site plans showing position of tank and 3 x hydraulics showing
rainwater system
Yes
No
Does the application require a new water meter?
If “Yes”, please refer to City of Gold Coast’s water and sewerage webpage for
more information on lodging an application for a water meter.
Yes
No
Will trade waste be discharged from the premises?
If “Yes”, please refer to City of Gold Coast’s water and sewerage webpage for
more information on lodging an application to discharge trade waste to the
Gold Coast wastewater system.
Yes
No
Does the application require a fire service?
If “Yes”, you may be required to supply calculations and a Gold Coast Water
Network Hydraulic Information Report.
Please refer to City of Gold Coast’s water and sewerage webpage for more
information.
Yes
No
Document #17239318 v51
Last updated 31/01/2017
Page 3 of 4
Supplementary to Form 1 Plumbing & Drainage
Section 4: Class 2 – 9 Commercial application (unsewered, on-site sewerage facility)
Is this an amendment to an existing approval?
Yes
$456.00 application fee
$103.00 per additional fixture
No
Yes
No
Previously approved BLD number
Is this a new application?
Is this an on-site sewerage facility including
fixtures?
Yes
$1004.00 application fee
$103.00 per fixture
No
Is this a conversion from septic to treatment
plant?
Yes
$704.00
No
Is this an on-site sewerage facility concurrence
fee application?
Yes
$357.00
No
Is installation of land application area only?
Yes
$213.00
No
Sub total $
Information checklist
Please advise that you have submitted the following forms and/or information with your application.
 2 x copies of a site and soil report for the on-site sewerage facility
proposal
Yes
No
 2 x scaled site plans showing the location of the proposed or existing
on-site sewerage facility, the land application area and all existing
structures on the property
Yes
No
 the distance from the land application area to the boundary of the
property
Yes
No
 the distance from the land application area to all impervious surfaces on
the premises, i.e. concrete paths and paved areas
Yes
No
 the distance from the land application area to any bodies of water that
may be affected by the effluent from the proposed on-site sewerage
facility
Yes
No
Payment options
Business partner account (BP)
Business partner name
Business partner number
Cash, cheque or credit card at any of Council’s branch offices. For branch office locations and operating hours,
please refer to Council’s website.
Please be advised that payment by credit card will incur a surcharge.
Cheque or money order may be posted to Council’s post office box address. Please ensure that you provide
adequate reference details or attachments to allow the cheque to be appropriately receipted.
Please note: Applications will not be accepted without payment.
Declaration
I declare that:
 The information provided in this form is complete and correct
 I have read the privacy notice
Signature
Document #17239318 v51
Date
Last updated 31/01/2017
Page 4 of 4