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Landowners consent to undertake a listed activity

By Justin Reed,2014-11-29 16:37
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Landowners consent to undertake a listed activity

    KZN Agriculture and Environmental Affairs

    Mnyango: eZolimo neZemvelo

    SIFUNDAZWE SAKWAZULU-NATALI

    Private Bag X9059

    PIETERMARITZBURG 3200

    Landowner’s consent to undertake a

    listed activity

    in terms of the requirements of section 16(1) of the

    Environmental Impact Assessment Regulations, 2006

Kindly note that:

    1. This document should be attached as an appendix to the application form for environmental

    authorization in terms of the National Environmental Management Act, 1998 (Act No. 107 of 1998)

    (as amended).

1. DETAILS OF APPLICANT

Project applicant:

    Trading name (if any):

    Contact person:

    Physical address:

    Postal address:

    Postal code: Cell:

    Telephone: Fax:

    E-mail:

Department of Agriculture & Landowner Consent Form Page 1 of 3

    Environmental Affairs, Version 1, August 2006

    KwaZulu-Natal

    2. DETAILS OF LANDOWNER

    (where the applicant is not the landowner) Landowner:

    Contact person:

    Postal address:

    Postal code: Cell:

    Telephone: Fax:

    E-mail:

3. PROJECT DETAILS AND ACTIVITIES

    APPLIED FOR

Project title:

Activities applied for:

    (please list all the activities applied for)

    Indicate the Activity No (s) (in Describe each listed activity: number and terms of the

    date of the relevant notice) :

    relevant notice:

    4. PROPERTY DESCRIPTION

Property description:

     (Farm name, portion etc.) Where a large number of properties are involved

    (e.g. linear activities), please attach a full list to this application. Town(s) or

    district(s):

    Physical (street)

    address of project:

    Department of Agriculture & Landowner Consent Form Page 2 of 3 Environmental Affairs, Version 1, August 2006

    KwaZulu-Natal

    5. CONSENT BY LANDOWNER

    I ____________________________________________________, declare under oath that, I:-

    ; Am the owner of the property described in Section 4 of this document; and ; hereby give my consent to:

    _____________________________________________________, the applicant as described in Section 1 of this document to undertake the proposed activity/ ies as described in Section 3 of this document on the abovementioned property.

Signature of the landowner

Date

    Department of Agriculture & Landowner Consent Form Page 3 of 3

    Environmental Affairs, Version 1, August 2006

    KwaZulu-Natal

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