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Schedule 12: Notice of Application for Renewal of Mining Licence to Owner and Occupier of Land

Mineral Resources (Sustainable Development) Act 1990 - Section 29(1)
Mineral Resources (Sustainable Development) (Mineral Industries) Interim Regulations 2018 - Regulation 26

Application for Renewal of Mining Licence No: 

1. Name and address of applicant(s) (if the applicant is a company, the registered address of the company):

Name:Name:
  
Postcode:Postcode:
Telephone:

Telephone:

    
Name:Name:
  
Postcode:Postcode:
Telephone:Telephone:

2. Correspondence Address:

Address: 
Postcode:

 

Notice is hereby given that an application for a renewal of a mining licence over land owned or occupied by you has been lodged with Earth Resources Regulation.

3. Particulars of Application:

Licence number:
Locality:
Area of land
Term of renewal applied for

Nature of proposed work program:

4. Signature of applicant(s):

 

……………………………………………………… ………………………………………………………

 

……………………………………………………… ………………………………………………………

5. Date of Application:

Enquiries may be made to:

Director, Statutory Authorisations
Department of Economic Development, Jobs, Transport and Resources
GPO BOX 2392
MELBOURNE VIC 3001
AUSTRALIA

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