The Planning and Development Act 2007 requires that the following information be kept on a public register:

•	the place to which an order relates; and
•	should the order be made, the directions in the order and whom the order is directed;

The name of the applicant for a controlled activity order will not be placed on the public register. However a copy of your application and any attachments will be sent to the lessee/occupier of the land on which the activity is occurring and to other appropriate Government agencies. The lessee/occupier of the land on which the activity is occurring may make submissions to the Planning and Land Authority.

Lease/Site Details Please Print

Block	
	Section 		Suburb		Unit No.		

Street Address	

Applicant Details Please Print

Surname	
		First Name		
		
Company Name if applicable	

Postal Address	

Suburb	
		State			Postcode		
				
Phone Number Business Hours			Mobile		
		
EMAIL ADDRESS	

Details of the Person/s on whom the Order is to be Directed Please Print

Surname	
		First Name		
		
Postal Address	

Surname	
		First Name		
		
Postal Address	

If more than two people please provide details on a separate sheet

Controlled Activity

Schedule 2 of the Planning and Development Act 2007 provides that the following controlled activities are activities subject to order.  Please tick the relevant box for the activity you wish a controlled activity order to be made.

•	Failure to comply with: 
(a)	a lease; or
(b)	if a lease is granted subject to the lessee entering into a development agreement and the lessee has entered into such an agreement – the development agreement.	•	Undertaking a development for which development approval is required
(a)	without development approval; or
(b)	other than in accordance with the development approval.	
•	 Managing land held under a rural lease other than in accordance with the land management agreement that applies to it.	•	Having a building or structure that was constructed without approval required by the Planning and Development Act 2007, Chapter 7 (Development Approvals).	
•	Using unleased Territory land in a way that is not authorised by a licence under the Planning and Development Act 2007 or permit under the Roads and Public Places Act 1937.	•	Failing to enter into a land management agreement as required under Section 286 of the Planning and Development Act 2007.	
•	Failing to keep a leasehold clean		

Controlled Activity Order Direction

The directions below are those which the Planning and Land Authority can make. Please tick the space adjacent to the order you are seeking in relation to the activity selected in part 4.

•	Not to begin a development without development approval.	•	To clean up a leasehold and keep it clean.	
•	Not to carry out a development without development approval.	•	Not to undertake a controlled activity other than a development.	
•	To carry out a development in accordance with a condition under the development approval that approved the development.	•	If the person to whom the order is directed is bound by a land management agreement – to comply with the land management agreement. 	
•	To demolish a building or structure, or a part of a building or structure, that has been constructed without development approval or permission required under a territory law.	•	To apply for development approval for a building or structure, or part of a building or structure, that has been constructed without development approval.	
•	To demolish a building or structure, or a part of a building or structure, that encroaches onto, over or under unleased territory land without approval granted under a Territory law.	•	To restore any land, building or structure that has been altered without development approval or permission required under a territory law	
•	To replace with an identical building or structure any Building or structure that has been demolished without development approval or permission required under a territory law.	•	To comply with the terms of a development approval to undertake development.

Activity Description

Please fuFully describe the activity that is occurring and why you believe the Authority should make the controlled activity order.

	

	

	

Applicant Declaration

I/we declare that all the information given on this form and its attachments is true and correct.

If signing on behalf of a company, organisation or Government agency:-

I/we the undersigned, declare I/we have the appropriate delegation or authority to sign on behalf of the company, organisation or Government agency.

Applicant Name(s)	

Applicant Signature (s)	
	Date		

An application fee is payable at the time of lodgement.  The current Fees and Charges booklet can be found on the Environment and Planning Directorate website www.environment.act.gov.au

Privacy Notice
The personal information on this form is provided to the Environment and Planning Directorate (EPD) to enable the processing of your application. The collection of personal information is authorised by the Planning and Development Act 2007.  If all or some of the personal information is not collected EPD cannot process your application. The personal information you provide may be disclosed where the Directorate reasonably believes that the use or disclosure of the information is reasonably necessary for enforcement-related activities conducted by, or on behalf of, an enforcement body. EPD’s Information Privacy Policy contains information about how you may access or seek to correct your personal information held by EPD, and how you may complain about an alleged breach of the Territory Privacy Principles. The EPD Information Privacy Policy can be found at www.environment@act.gov.au 

Contact Details:
Environment and Planning Directorate
Customer Service Centres
GPO Box 158, Canberra City 2601
8 Darling Street Mitchell, ACT 2911
16 Challis Street Dickson ACT 2602
Business Hours: 8.30am to 4.30pm weekdays (excluding Public Holidays)
Phone: (02) 6207 1923	TTY: (02) 6207 2622
Email: epdcustomerservices@act.gov.au	Website: www.environment@act.gov.au