Document ID: chunk:federal_register_of_legislation:F2018N00131:schedule:1:p1
Version: federal_register_of_legislation:F2018N00131
Segment Type: schedule
Provision Reference: sch 1 (pt 1/2)
Character Range: 118156–123160

Schedule 1

Shire of Christmas Island

PUBLIC HEALTH ACT (WA) (CI) 2016

                       APPLICATION FOR REGISTRATION OF A LODGING HOUSE
[Clause 8.1.4]

  To: Chief Executive Officer, Shire of Christmas Island
  I/We, ...................................................................................................................................
                      (Full name of Applicant/s)
  of..........................................................................................................................................
                   (Residential Address of Applicant/s)
  apply for the registration of premises situated (or to be situated) at
  ............................................................................................................................................
  ............................................................................................................................................
  as a lodging house to be classified as—
     *  a lodging house;
     *  a short term hostel;
     *  recreational campsite;
     *  transient workforce accommodation; or
     *  serviced apartments
  (* Specify which is to apply)
  and for my name to be entered in the Register as the keeper of the lodging house.

DESCRIPTION OF LODGING HOUSE

 Number of storeys..........................................

 Rooms for private use
 Number Area
Laundries/toilets/bathrooms  .......................  ........................
Bedrooms                     .......................  ........................
Dining Rooms                 .......................  ........................
Kitchens                     .......................  ........................
Sitting Rooms                .......................  ........................
Other Rooms (specify)        .......................  ........................

 Rooms for lodgers
       Number Area
Bedrooms         .......................  ........................
Dining Rooms     ......................   ........................
Kitchens         .......................  ........................
Sitting Rooms    .......................  ........................
Other (specify)  .......................  ........................

 Sanitary Conveniences for male lodgers
 Number
 Toilets .......................
 Urinals .......................
 Baths ....................... Showers .......................
 Hand wash basins .......................
 Sanitary Conveniences for female lodgers
 Number
 Toilets .......................
 Baths ....................... Showers .......................
 Hand wash basins .......................

 Laundry Facilities   Number
 Wash troughs ....................... Washing machines .......................
 Drying cabinets or clothes lines .......................

 Additional Details
   (a)   Lodgers' meals will be provided by the manager/keeper/lodgers.
   (b)   The keeper will / will not reside continuously on the premises.
   (c)   Name and occupation of proposed manager if keeper resides elsewhere      …………………………………………………………………………………………..
 (d)   There will be ........family members residing on the premises with the keeper /manager.

Application fee of $ .............................is attached.

 ...........................................................    ...........................................................
 (Signature of Applicant/s)      (Date)

_________________________

                        Schedule 2

                      Shire of Christmas Island

                      PUBLIC HEALTH ACT (WA) (CI) 2016

CERTIFICATE OF REGISTRATION OF A LODGING HOUSE
[Clause 8.1.2]

 THIS is to certify that the premises situated at

 ................................................................................................are registered as a Lodging House and classified as—

    *  a lodging house;
    *  a short term hostel;
    *  a recreational campsite;
    *  transient workforce accommodation; or
    *  serviced apartments.

 until 30 June ....................., on the following conditions—

    1.   That ....................................................., whose name is entered on the register of keepers of the Shire of Christmas Island, continues to be the keeper of the lodging house;

    2.   That ......................................................, appointed by the keeper to be the manager of the lodging house continues to be the manager of the lodging house;

     3.   That the Certificate of Registration is not cancelled or revoked;

    4.   That  the  maximum  number  of  rooms  to  be  used  as  sleeping  apartments  for

    lodgers is .............................................................; and

     5.   That  the  maximum  number  of  lodgers  accommodated  on  the  premises  shall  not  exceed
           .................................................. .

  This certificate of registration is issued subject to the Public Health Act