Download Swimming Pool Certificate Of Compliance Template for Free

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Application Form
Swimming Pool Certificate of Compliance
PO Box 183 Section 22D Swimming Pools Act 1992
Camden NSW 2570
02 4654 7777
Office use only
Receipt No Receipt Date Fee Paid $ Application No.
Location Address of Swimming Pool
Unit/Street No Street Name
Suburb Post Code
Lot No DP/SP No
Purpose for application for Certificate of Compliance
Sale of property:
Lease of property:
Other: Please specify: ……………………………………………………………
Swimming Pool Details
Approximate year the swimming pool was approved/constructed…………………………………..
Development/Building Application number (if known):………………………………………………..
Type of swimming pool: In-ground Semi in-ground Above ground Spa/Hot Tub SwimSpa
Construction materials Concrete Fibreglass Metal Other………………………..
Has the swimming pool barrier/fence (including boundary fences) been modified since original construction of
the swimming pool? Yes
No
If yes, approximate year of modifications:………………………..
Does the swimming pool barrier/fence incorporate any glass panels? Yes No
If yes, certification from a Glazier will need to be provided prior to the issue of any Certificate of Compliance.
NSW Swimming Pool Register No……………
(NB Pool must be Registered to apply for a certificate)
Applicant Details / Owners Consent (Note: must be the owner of the land)
Title Given Name Family Name
Organisation/Company
Address
Contact Phone Number Email Address
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Swimming Pool Certificate Of Compliance Template
source: camden.nsw.gov.au
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