application for estimate for council to
TRANSCRIPT
Central Coast Council
Application for Estimate for Council to:
Connect Development to Sewerage Relocate / Adjust Existing Sewerage Reline Existing Sewer Raise / Lower / Adjust Sewer Manhole
Please send estimate to:
Company Name:
Contact Person:
Address:
Phone No:
Signature:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
________________________________ Email: _________________________ _________________________________ Date: _______________________________
Type of Development:
Dev. Application No:
Location of Work:
Address:
__________________________________________________________________
_____________________________________________
Lot: _______________ Section: ____________ DP: ____________________
__________________________________________________________________
Please provide an estimate for Council to carry out the following work: (Plans/Drawings are Attached - YES/NO)
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
OFFICE USE ONLY File No: Works Order:
ADMINISTRATION OPERATIONS ____/____/____
____/____/____
____/____/____
Received
Estimate Sent Payment
Received Adjustment
Completed ____/____/____
____/____/____
____/____/____
$____________
____/____/____
____/____/____
____/____/____
____/____/____
Received
Design/Estimate Prepared
Estimated Cost
Works Order Received
Programme Start
Works Completed
Work As Executed to I&D
Final Cost $____________
V1.1 26.3.19 D13495889
Wyong Office: 2 Hely St / PO Box 20 Wyong NSW 2259 Gosford Office: 49 Mann St / PO Box 21 Gosford NSW 2250
P 1300 463 954 l E [email protected] l W centralcoast.nsw.gov.au l ABN 73 149 644 003
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