Document ID: chunk:federal_register_of_legislation:F2018N00131:schedule:3:p2
Version: federal_register_of_legislation:F2018N00131
Segment Type: schedule
Provision Reference: sch 3 (pt 2/2)
Character Range: 133480–138683

2016

      APPLICATION FOR CONSENT TO ESTABLISH AN OFFENSIVE TRADE
[Clause 9.1.2]

 To: Chief Executive Officer, Shire of Christmas Island

 I/We,....................................................................................................................................................
 (Full Name of Applicant/s)

 of.........................................................................................................................................................
 (Residential Address of Applicant/s)

 apply for consent to establish an offensive trade being

 ............................................................................................................................................................
 (Description of Offensive Trade)

 in or upon............................................................................................................................................
 (Location of the House or Premises)

 Notice of my / our intention to make this application was advertised in

 ............................................................................................................................................................
 (Name of Newspaper)

 on ............................................................................................................................................................
                     (Date of Advertisement)

 Plans and specifications of the buildings proposed to be used or erected in connection with the proposed offensive trade are attached.

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

__________________

                        Schedule 10

                      Shire of Christmas Island

                      PUBLIC HEALTH ACT (WA) (CI) 2016

                      APPLICATION FOR REGISTRATION OF PREMISES FOR OFFENSIVE TRADE
 [Clause 9.1.4(a)]

 To: Chief Executive Officer, Shire of Christmas Island

 I/We,  ............................................................................................................................................................
                    (Full Name of Applicant/s)
 of ............................................................................................................................................................

 ............................................................................................................................................................
                  (Residential Address of Applicant/s)

 apply for registration, for the year ended ............................................................................................

 of ........................................................................................................................................................
                     (Location of Premises)

 being premises in or upon which there is (or is to be) carried on an offensive trade, namely

 ............................................................................................................................................................

 ............................................................................................................................................................

                   (Description of Offensive Trade)

 under the business name of ............................................................................................................

 The prescribed registration fee $ ....................................... is attached.

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

__________________

                        Schedule 11

                      Shire of Christmas Island

                      PUBLIC HEALTH ACT (WA) (CI) 2016

 CERTIFICATE OF REGISTRATION OF PREMISES FOR OFFENSIVE TRADE
[Clause 9.1.5]

 This is to certify that the premises situated at

 ............................................................................................................................................................

 of which...................................................................................................................... is the occupier;

 are registered for the carrying on of the trade of

 ......................................................................................................................................................

 Trade Name
 ......................................................................................................................................................

 This registration expires on .................................................day ……..…............................……

 Dated this................................................. day of ........................................................................

 …..........................................................................
 Environmental Health Officer,
 Shire of Christmas Island.

__________________