Business Approvals Application

Before you start this form, we recomend that you contact council's Permit Support Officer to discuss your business proposal by calling 1300 520 520 or email pso@buloke.vic.gov.au

Once you have lodged this application form, it will be forwarded to the relevant business units for assessment and you may be contacted by them for more information. The units related to the business approval process include:

• Economic Development & Tourism

• Planning

• Building

• Public Health

• Local Laws

Fees and payment methods 

Once your application is lodged, we will send you a breakdown of the fees with payment options. 

After you submit your application

You will be contacted by our Permit Support Officer to discuss next steps for your application.

Permits included in this application form

(You'll only be shown the sections you need)

  • Applicant Details
  • Planning Permit
  • Building permit
  • Register a fixed location food business
  • Register an accomodation business
  • Register a hairdressing, beauty therapy or skin penetration business
  • Register for footpath trading
  • Town Planning Fee schedule
  • Declaration
Based on your discussion with the Permit Support Officer or the online assessment tool, please select which permits you need.:*



  Section 1 - Applicant Details

Before you start this form, we recomend that you contact council's Permit Support Officer to discuss your business proposal by calling 1300 520 520 or email pso@buloke.vic.gov.au


This section must be completed by all applicants

Please submit your personal details and the details of your business. You may include two sets of details if the application is made on behalf of the business owner.

Business Owner


Name*
Address*
Is the applicant the business owner?*

Secondary Business Owner or Primary Contact (if applicable)

Name*
Address*
Business Details

Business trading address*
Expected date to open business (if known)
Have you been in contact with Council's Permit Support Officer?*

Where more than one individual is listed as a business owner, an authorised person may sign. I understand and acknowledge that the information provided in this application is true and complete to the best of my knowledge.

Use your mouse or finger to draw your signature above
Date*



 Section 2 - Apply for a planning permit
  (New permits or amendments to existing permits)  

You must complete this section if planning permission is required for a change in use and/or development of land.  Prior to completing this section, please contact Town Planning to discuss your proposal and determine whether you require planning permits. A permit may be required if you will:

  • use the building land for a different purpose to how it is used now
  • develop or undertake external buildings and works or internal works to a building/site with special planning controls (e.g. heritage)
  • display external signage (e.g. business identification sign(s) or illuminated sign(s))
  • change the areas in your business that alcohol can be served or increasing serving hours
  • reduce the number car parking or bicycle facilities required on your land

If you have any queries, please contact the Planning Department on 1300 520 520.

Land details

Is this application for a new permit or an amendment to an existing permit?*
Are you proposing to change the use of your land?*
Are you proposing any buildings and works?*
Are you proposing any reduction or waiver in car parking or bicycle facilities?*
Are you proposing any signage?*
Are you proposing a liquor license / change to an existing license?*
Does your application qualify as a VicSmart application?*
Acknowledgement *

Please note the below file upload fields allow only one document to be uploaded per field.  

Should you have more than six (6) documents to upload, please contact the Permit Support Officer on ph. 1300 520 520. 

No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.
Eg. Plans, elevation drawings, land capability assessments, planning reports etc.
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.



Section 3 - Building permits

You will require a building permit if you will:

  • build a new premises
  • make any internal or external changes to the building on which your business will be located (this includes the fence lines or installation of permanent structures such as shade sails)
  • changing the use or number of people occupying your building
  • change the use of your building (eg. warehouse to sporting facility)
  • require accessibility to people with disabilities (e.g. front entrance level with footpath, wheelchair accessible toilets)

Please Note

  • Building permits can be sought from any registered building surveyor within Victoria.

To Municipal Building Surveyor


From

Is the person completing this form the owner or an agent of the owner?*
Name*
Postal address of applicant*
Is the address for serving or giving documents the same as the postal address?*
Address for serving or giving documents*
Indicate if the applicant is a lessee or licensee of Crown land to which this application applies
Indicate if a lessee of the building, of which parts are leased by different persons, is responsible for the alterations to a part of the building leased by that lessee

Ownership details (only if agent of owner listed above)

Name*
Address*
Contact Person*

Property Details

Address*

Builder

Name*
Postal Address*

[If the builder is carrying out domestic building work under a major domestic building contract, attach an extract of the major domestic building contract showing the names of the parties to the contract in relation to the proposed building work and a copy of the certificate of insurance (if applicable).]


*Natural person for service of directions, notices and orders (if builder is a body corporate)

Name*
Address*

Building practitioner or architect engaged to prepare documents for this permit

[List any building practitioner or architect engaged to prepare documents forming part of the application for this permit.]

Name
Name
Name
Nature of building work*

*Owner Builder

I intend to carry out the work as an owner-builder?*

Cost of building work

Is there a contract for the building work?*
$

Stage of building work

$
Use your mouse or finger to draw your signature above
Date/Time*
Checklist of documents to include with application:

No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.

The proposed floor plan will need to show:

  1. The number of persons the building will accommodate (patrons and staff)
  2. The location and number of sanitary facilities to accommodate the occupants; (closet pans, urinals, washbasins - including ambulant and accessible sanitary facility)
  3. The location of exit signs including directional exit signs and emergency lightingd.
  4. Demonstrate compliance with AS 1428 - Design for access and mobility
    1. Can a person in a wheel chair enter the building (is there a step), if so show a detail of proposed ramp
    2. State the clear width of the exit door
    3. Path of travel within the building and access to sanitary facilities for people with a disability
  5. Location of fire fighting equipment, such as portable fire extinguishers, hose reels, fire hydrants, sprinklers
  6. Details of artificial lighting and mechanical ventilation
  7. Location of cooking appliances (stove, cooktop, deep fryer, etc.) and exhaust canopy




Section 4 - Food Premises

  • for a fixed-location food business (including home-based premises), you will need to complete this section
  • for a temporary or mobile premises, you need to apply for a permit using: streatrader.health.vic.gov.au, but also complete this section if you store or prepare food at home for trading use•registration of your business applies until 30 June each calendar year
  • you must read, understand and comply with the Food Safety Standards
  • http://www.foodstandards.gov.au/Pages/default.aspx and Council's Construction of Food Premises Guidelines, available on Buloke Shire Council’s website
  • https://www.buloke.vic.gov.au/food-registration
  • if your business primarily involves the manufacturing or production of dairy you will need to register your business with Dairy Food Safety Victoria (dairysafe.vic.gov.au) instead of Council
  • if your business primarily involves the manufacturing or production of red meat, poultry or seafood you will need to register your business with PrimeSafe (primesafe.vic.gov.au) instead of Council
PREMISES TYPE

Food Classes
The type of food that you prepare and sell will determine your Risk Classification. Your fee will be determined by your Risk Classification and size of premises. Some examples have been provided in the table below.  
Please select the appropriate class and premises type for your business.

Class
Description
Premises type (but not limited to)
Fee range

New business Note:

For new businesses a pro-rata fee may apply.
Class 1

Food being prepared or served exclusively for vulnerable groups
  • Aged care service
  • Hospital
  • Child care
  • Meals on wheels service
$325.00
Class 2 
Food premises selling or handling unpackaged high risk food
  • Cafes, delis, take-away premises, restaurants
  • Home businesses preparing cakes containing cream, custard and/or raw eggs
  • Manufacturer
  • Supermarket
  • Sporting club
  • School Canteen
  • Other food businesses handling unpackaged high risk food
$320.00
Class 3
Food premises selling or handling unpackaged low risk food
  • Greengrocer that only sells cut fruit, vegetables and/or packaged food
  • Home businesses preparing low risk baked products
  • Wholesaler / distributor / importer of food- food is sold to other food businesses
  • Sporting club or Community Group
  • Community group* - cooked on site and served immediately - non-profit, all food handlers are volunteers
  • Other food business
$220.00
No feel applies to community groups
Class 4
Food premises selling packaged low risk food or sale of uncut fruit and vegetables
  • Pre-packaged low risk food such as confectionary, crisps, frozen ice cream, bottled drinks. For example newsagents, pharmacies, video stores and some milk bars; or
  • The same to members of the public or the wholesale of whole fruit or vegetables
Notification only
No fee applies













Which food class does your business belong to?*
Class 1 Premises type*
Class 2 Premises type*
Class 3 Premises Type*
Class 4 Premises Type*

Premises Details
Sit-in dining area?*
Sale of tobacco products?*
Tobacco vending machine*
Liquor license? If yes, please complete the Planning section of the form*
Type of liquor license?*

 Class 1 & 2 Premises only

Food Safety Supervisor 

A Food Safety Supervisor (FSS) is a person in your business who is responsible for food safety, hygiene and staff training and must be authorised to supervise other food handling staff. 

A FSS must hold a certificate of attainment in the relevant food industry. To find out more, see information about Food Safety Supervisors on the DHHS website http://bit.ly/food-safety-supervisors


Food Safety Supervisor Name*

Food Safety Program 

A Food Safety Program (FSP) is a document in your business, which outlines food safety and hygiene requirements. The Food Safety Program is required to be kept at the premises to which they relate. Council can provide you with the Department of Health and Human Services (DHHS) Food Safety Program Template for an additional fee or it can be downloaded from http://bit.ly/program-templates-class-2

Food Safety Program *

All Class 1 businesses must have an independent Food Safety Program.


Class 3 Premises only 


Food Safety Records 

Class 3 premises are required to keep minimum records of the food business activities. The proprietor of the class 3 premises must ensure that the required records are kept at the premises to which they relate. Templates can be downloaded from http://bit.ly/Minimumrecords-templates-class-3



 Trade Waste Consent

You will need to contact Grampians Wimmera Mallee Water on telephone 1300 659 961 to determine whether a grease trap is required to be installed at your business and obtain trade waste consent. If required, please consult with Council’s Public Health Officer to discuss the most suitable location. Refer to the Grampians Wimmera Mallee application guide here: https://bit.ly/2G8JRUK



 Documents to upload
No File Chosen
File uploads may not work on some mobile devices.
It is imperative that your premises comply with the Food Safety Standards. It will be an advantage to provide plans and specifications of fixtures and finishes so an officer can review and provide you with a report. This service is free of charge. I have attached plans for review with this application. Please note: Plans may differ from plans submitted to Town Planning or Building Department
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.



Section 5 - Accomodation Business


  • for accommodation related business, you will need to complete this section. 
  • registration of your accommodation business applies until 30 June each calendar year 
  • accommodation businesses are not transferrable, but you can request a pre purchase inspection report. Please tick the option under ‘Confirmation of actions’ if you wish to receive this service 
  • if your business will sell food or drinks to guests or the public you also need to complete section 2 of this form (Food Premises) 


Please note that the Fee Range Based on pro rata is $220

Type of business*

For an additional fee of $220.00, Council’s Public Health Department offers a pre-purchase inspection report for those considering purchase of an existing business. 

This process may take up to seven (7) days from receipt of payment. 

The release of any business information is conditional upon the current proprietor’s written consent.

I would like to request a pre-purchase inspection report.*
I acknowledge there is a fee for this report and the current propietor's consent is required.

To proceed with the pre-inspection report request, a 'Request for Information and Documents' form must be submitted with the proprietor's consent to buloke@buloke.vic.gov.au. 

To obtain a copy of this form please contact the Permit Support Officer on 1300 520 520.  

No File Chosen
File uploads may not work on some mobile devices.
Plans are drawn to scale of not less than 1:100 showing the proposed use of each room, size of all rooms and the total number of people who may occupy the rooms.
No File Chosen
File uploads may not work on some mobile devices.
I confirm I have been granted a license as a fit and proper person to operate a rooming house



Section 6 - beauty and skin penetration premises


  • for a health-related business (including home-based or mobile premises), you will need to complete this section 
  • registration of your business is per financial year and expires on 30 June 
  • you must read, understand and comply with the Public Health and Wellbeing Regulations 2009 http://bit.ly/PHWB-regulations-2009 and Guidance Notes for fit out for personal care and body art industry premises available on Buloke Shire Council’s website https://www.buloke.vic.gov.au/health-and-prescribed-accommodation-registration
  • low risk premises are not transferable, but you can request a pre-purchase inspection report. Please tick the option under ‘Confirmation of actions’ if you wish to receive this service 
  • if your business will sell food or drinks to guests or the public you also need to complete section 2 of this form (Food Premises) 


Type of Business
Fee (pro-rata)
Low Risk
  • hairdresser / barber
  • Makeup - applications of cosmetics that does not involve skin penetration or tattooing
 $175
Medium / High Risk 
  • Manicure/pedicure
  • Facial or body treatments
  • Foot spa treatments
  • Hair removal (electrolysis/IPL/laser/wax/threading)
  • Ear piercing (gun only) 
  • Body piercing or other skin penetration procedures
  • Tattooing/removal -includes permanent or semi-permanent makeup or cosmetic tattooing
  • Dry needling
  • Colonic irrigation
1 activity - $175
More than 1 activity (e.g. hairdressing & beauty therapy or hairdressing & ear piercing) - $220
Other
To be discussed









What type of health business do you have?*
Is your business a mobile business?*
Please note that mobile services for medium/high risk activities are not permitted

Fully dimensioned floor plans, drawn to scale, are required showing the following:

  • every part of the premise including yards and outbuildings
  • specific use/work processes to be carried out in each room or part of establishment
  • the location and type of all fittings and fixtures, surface finishes, furniture, shelving, benches etc. 

A formal assessment response of these plans will be provided by Council's Public Health Department. 

Please note: plans may differ from plans submitted to Planning or Building Departments.

No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.
For an additional fee of $220.00, Council’s Public Health Department offers a pre-purchase inspection report for those considering purchase of an existing business. 
This process may take up to seven (7) days from receipt of payment. 
The release of any business information is conditional upon the current proprietor’s written consent.

I would like to request a pre-purchase inspection report.*
I acknowledge there is a fee for this report and the current propietor's consent is required.

To proceed with the pre-inspection report request, a 'Request for Information and Documents' form must be submitted with the proprietor's consent to buloke@buloke.vic.gov.au. 

To obtain a copy of this form please contact the Permit Support Officer on 1300 520 520.  

Proposed Settlement Date


 
 Section 7 - Footpath Trading
  • you will need to apply for a Footpath Trading permit from Council if you would like to offer outdoor dining, advertising signs or display of goods. 
  • permits are valid from the date of issue until 31 August, after which they are renewed annually. Fees are calculated per annum or on a pro rata basis for businesses not operating until after 1 Feb. 
  • fees are set annually by Council as part of the Council’s budget plan. 
  • please ensure compliance with all items in the declaration overleaf. If you are unsure about compliance or require additional assistance please contact Local Laws Department for support on 1300 520 520. 
Advertising*
Display of goods *
Street activation*
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.
No File Chosen
File uploads may not work on some mobile devices.

 Declaration
Have you read and agree to comply with Council’s Footpath Trading Guidelines. *

If you are unsure about compliance or require additional assistance please contact Local Laws for support on 1300 520 520. 


I agree to indemnify and keep indemnified the Buloke Shire Council (The Council), and its servants and agents and each of them from and against all actions, costs. claims, charges, expenses, penalties, demands and damages whatsoever which may be brought or made or claimed against them, or any of them, arising out of or in any way related to the granting of this Permit and be directly related to the negligent acts, errors or omissions of The Applicant. The Applicant’s liability to indemnify the Council shall be reduced proportionately to the extent that any act or omission of the Council, contributed to the loss or liability. The Applicant also agrees to hold harmless the Council, its servants and agents, and each of them from claims resulting from damage, loss, death or injury whatsoever which may otherwise be brought or made or claimed by The Applicant against the Council, except to the extent that The Principal is negligent.

Please confirm your agreement to the above indemnity statement. *


 
 Section 9 - Declaration

Payment is required prior to your planning permit and/or building permit being processed.  

Based on your permit submission an invoice will be issued for the payment of permit fees. 

If you have any questions, please contact the Permit Support Officer on 1300 520 520.

Use your mouse or finger to draw your signature above
Name*
Date/Time*
Save and Resume Later
Progress
Powered by Formstack Create your own form ›
Cancel
Confirm