Application Form for a Commercial Producer's Licence - Timber - Western Australia Australia

This fillable "Application Form for a Commercial Producer's Licence - Timber" is a document issued by the Western Australia Department of Parks and Wildlife specifically for Western Australia residents.

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Wildlife Conservation Act 1950  
Section 23D Reg 56F 
PN 
Application for a Commercial Producer’s Licence - Timber
To sell protected (native) flora in the form of timber, taken from, or grown and cultivated on, private
property
Completed forms should be returned to:
Further information on the licensing requirements
is available from DPaW Wildlife Licensing Section
Department of Parks and Wildlife
Phone:
(08)
9219 9836
Locked Bag 30 Bentley Delivery Centre WA 6983
Email: wildlifelicensing@dpaw.wa.gov.au
Or faxed to (08) 9219 8242 or emailed.
COMMERCIAL PRODUCER’S (PN) LICENCES ARE ISSUED FOR A 1-YEAR PERIOD, WITH A $25 FEE.
PLEASE ALLOW TEN (10) WORKING DAYS TO PROCESS COMPLETE AND CORRECT APPLICATIONS.
PLEASE NOTE THAT RENEWAL OF A LICENCE IS DEPENDENT ON SATISFACTORY COMPLETION AND
SUBMISSION OF FLORA RETURNS.
Applicant:
Surname
Other Names
Dr/Mr/Mrs/Miss/Ms
Personal Address (residential)
Postcode
Address (postal)
Postcode
Address Change Yes/No
Day Phone No.
(please state previous address)
Business Name (if applicable)
Date of Birth:
/
/
Previous Licence No.:
Expiry Date:
Email Address:
PN0……………..
/
/
@
Land to which application relates
(Identify each. Note: Proof of authorisation is required- see Proforma
page):
Name of Local Government
Location/Lot Number
Owner or Occupier
Property Name
Authority (e.g. Shire)
(eg. Avon Loc 123)
Timber to which application relates
(Identify each):
Natural (P)
Number of Plants to be Taken or
Scientific Name
Common Name (if any)
or
Area of Plants to be Taken
(e.g. Eucalyptus marginata)
Cultivated (A)
Page 1 of 3
Wildlife Conservation Act 1950  
Section 23D Reg 56F 
PN 
Application for a Commercial Producer’s Licence - Timber
To sell protected (native) flora in the form of timber, taken from, or grown and cultivated on, private
property
Completed forms should be returned to:
Further information on the licensing requirements
is available from DPaW Wildlife Licensing Section
Department of Parks and Wildlife
Phone:
(08)
9219 9836
Locked Bag 30 Bentley Delivery Centre WA 6983
Email: wildlifelicensing@dpaw.wa.gov.au
Or faxed to (08) 9219 8242 or emailed.
COMMERCIAL PRODUCER’S (PN) LICENCES ARE ISSUED FOR A 1-YEAR PERIOD, WITH A $25 FEE.
PLEASE ALLOW TEN (10) WORKING DAYS TO PROCESS COMPLETE AND CORRECT APPLICATIONS.
PLEASE NOTE THAT RENEWAL OF A LICENCE IS DEPENDENT ON SATISFACTORY COMPLETION AND
SUBMISSION OF FLORA RETURNS.
Applicant:
Surname
Other Names
Dr/Mr/Mrs/Miss/Ms
Personal Address (residential)
Postcode
Address (postal)
Postcode
Address Change Yes/No
Day Phone No.
(please state previous address)
Business Name (if applicable)
Date of Birth:
/
/
Previous Licence No.:
Expiry Date:
Email Address:
PN0……………..
/
/
@
Land to which application relates
(Identify each. Note: Proof of authorisation is required- see Proforma
page):
Name of Local Government
Location/Lot Number
Owner or Occupier
Property Name
Authority (e.g. Shire)
(eg. Avon Loc 123)
Timber to which application relates
(Identify each):
Natural (P)
Number of Plants to be Taken or
Scientific Name
Common Name (if any)
or
Area of Plants to be Taken
(e.g. Eucalyptus marginata)
Cultivated (A)
Page 1 of 3
Application for a Commercial Producer’s Licence- Timber
Harvest/salvage details
: How is the timber being sourced? (tick the appropriate box)
Harvested from a plantation; a plantation is defined in Section 3 of the EP Act as “one or more groups of
trees, shrubs or plants intentionally sown, planted or propagated with a view to commercial exploitation”
OR
Salvaged from a valid clearing operation; in which case you will need to provide details of the operation in
the below table
Please provide details of:
Clearing Permit (under the EP Act 1986) No.
CPS………………………
OR
Exemption No. :
Attach further evidence supporting this
Demonstrated evidence of the activity being
exempt from requiring a clearing permit
(eg. approved building envelope if exemption
under the EP Act 1986
(eg. Reg 5, Item 1)
Reg 5, Item 1, etc)
OIC required?
Under the Forest Management Regulations 1993, the removal of timber in log form from private
property for the purpose of processing at a sawmill requires an Owner’s Identification Code (OIC) which are
obtained through DPaW. (tick the appropriate box):
OIC not required: timber to be processed on site (tick)
Application for OIC attached (tick)
OIC already held (tick)
Provide OIC number:
.
Payment
(Please select one of the following payment methods):
Cheque enclosed
Money order enclosed
Payment made at DPaW office (refer to ‘Office Use Only’ section below)
Credit Card (complete ‘Credit Card Payment’ section below)
No responsibility will be taken for cash payments sent via mail.
Credit Card Payment
(VISA & MASTERCARD ONLY)
**Please print clearly**
               
__________________________________
____/____
Name of Cardholder:
Expiry Date:
___________________________________________
Signature of Cardholder:
/
/
Signature of Applicant
Date
NAME OF RECEIPTING OFFICER:
RECEIPT NUMBER:
OFFICE USE ONLY:
..................................................................................
..............................
SIGNATURE:
DATE:
/
/
..................................................................................
POSITION HELD & OFFICE LOCATION:
AMOUNT:
$
.00
..................................................................................
Page 2 of 3
Application for a Commercial Producer’s Licence-Timber
Proforma letter (for private property owner/occupier) to authorise other persons to harvest and sell
protected flora from land stated below, and apply for a licence issued under the Wildlife Conservation
Act 1950 to do so.
Land owner/occupier details:
…………………………..……..
Name of the land owner/occupier
: …………
(delete whichever does not apply)
:
…………………………………………...
Postal address of the land owner/occupier
……………………………………………
……………………………………………
: ………………………………………………..…
Contact telephone number for the land owner/occupier
Land permission details:
Please be advised that as the owner/occupier
of the property:
(delete whichever does not apply)
Property name:
………………………………………….………..
Lot/Location No(s) or Street Address:
…………………………………………….……..
Local Government Authority:
………………………………….……….……….
…………………………………………….. (
) of
I give permission for
print name of applicant
……………………………………………………….……………..
)
to harvest and sell the
(print address
following species of protected flora from my property as listed above.
Flora species to which this authorisation applies:
Either tick the ‘All species’ box, list the species in the
space provided, or tick the ‘List attached’ box and attach and sign a list:
……………………….……………
All species
OR
List attached
OR
…………………………….……….
…………………………….……….
…………………………….……….
…………………………….……….
Period for which this authorisation applies:
Either tick the ’12 months from date of issue’ box, or state a
time period (
Note: Permissions can only be granted for a maximum of 12 months):
12 months from date of issue
…..…/……/20….. to ………/……/20.….
OR
Special conditions that apply to this authorisation
(e.g. area, methods, use of facilities):
………………………………………………………………….……………………………………………………
.…………………………….………...……………………………………………………………………….
Signed .......................................…………………
This proforma may be photocopied to allow for
attaching multiple permissions for multiple private
Name(Print): …………………………….…………
properties.
Date
............../............./20.............
Page 3 of 3

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