Strathbogie Shire Council

Tel 24/7: 1800 065 993

Travel Exemption Permit Application Form

Travel Exemption Permit Application

The State Government and Department of Health and Human Services (DHHS) requires the following form to be submitted by any landowner wishing to travel to Strathbogie Shire to undertake fire and flood preparedness works.


This permit application form is for the property I/we own located at:

Number (*)

Invalid Input
Street Name (*)

Invalid Input
Suburb/Town (*)

Invalid Input
Post Code (*)

Invalid Input
Property Assessment Number (as found on your Rates Notice) (*)

Invalid Input

I am an owner of this property listed on Strathbogie Shire’s rates notice:

First Name (*)

Invalid Input
Last Name (*)

Invalid Input

My usual place of residence is:

Number (*)

Invalid Input
Street Name (*)

Invalid Input
Suburb/Town (*)

Invalid Input
Post Code (*)

Invalid Input

I will be travelling with the following people who also usually live in the same household (you cannot travel with anyone that you do not usually live with):

First and Last Name

Invalid Input
First and Last Name

Invalid Input
First and Last Name

Invalid Input
First and Last Name

Invalid Input



Invalid Input

I wish to be at my property from:

(*)


Invalid Input
Start Time (*)

Invalid Input
(*)


Invalid Input
End Time (*)

Invalid Input

*** Please Note: You are only allowed to leave your home in Melbourne for a total of 72 hours, which includes travel to and from your property in our shire.

I will be doing the following emergency preparation works at my property: (tick boxes to be used for ease of completion) (*)









Invalid Input
Other - please specify

Invalid Input

Please note that should you be issued a permit to travel, you will need to abide by the following declaration:


Owner Declaration

I am traveling for the sole purpose of undertaking summer preparedness works to my property. I agree I will strictly adhere to the following conditions: (*)







Invalid Input

Please enter your email address below to receive your permit application response online otherwise a response will be mailed to your usual place of residence.

Your Email Address (*)

Invalid Input

Please enter your phone number so that we may contact you with any questions about this application.

Your Phone Number: (*)

Invalid Input



Featured Links

Translate:
Top of Page