:

Amofo AkwoZulu-Notoli

Heritoge KwoZulu - N otol

Erfenis KwoZulu-Nolol

PO Bor 2685

Pieterrraritzburg 3 200

Tel: 0i3 i94 65.11

Fax: 033 -19.1 6--sil

E mai I : amafa.pnr b2@nrrveb.co.zir

Website: lwlrv.heritagekzn.co.za

NEEDS & DESIRABILITY APPLICATION FORM

ln terms of the KwaZulu Natal Heritage Act No. 4 of 2008 and the National Heritage Resources ActNo.25 of 1999 (Section 38 (1)), a is required to carry out certain listed activities.

PLEASE NOTE

It is an offence in terms of section 34. of the KwaZulu Natal Heritage Act, to make false statement orfailto provide required information in this application.

ALL APPLICATION FORMS AND PROOF OF PAYMENT ARE TO BE FORWARDED TO:AMAFA KWMULU NATAL, ARCHAEOLOGY DEPARTMENT 195 LANGALIBALELE STREET

PIETERMARITZBURG. 3201/ BOX 2685 PIETERMARITZBURG 3200.

Kindly note that:1. Kindly note that with effect from 1"tof April 2010 an application fee

will be charged for Needs & Desirability applications and Permitapplications.

2. lncomplete applications will not be processed until they arerevised.

3. All information filled in on this form will become public informationon receipt by this department. Any interested and affected partyshould be provided with information contained in this applicationon request, during any stage of the application process.

4. No faxed or e-mailed applications will be accepted, only printedcopies.

SUBMISSION FEESRegulations make provision forthe agency to charge a submission fee. A administration fee ofR600.00 is payable to Amafa aKwaZulu Natali by postal order or bank deposit / EFT prior tothe processing of this application. Banking Details in case of direct deposits:ABSA BANK: Branch: ULUNDIBank Code: 630330 Account in the name of AMAFA AKWAZULU- NATALIAccount No- 40-5935€024NB: Proof of payment to be forwarded (faxed, posted or delivered) to Amafa, to be referencedwith applicants name and date

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NEEDS & DESIRABILITY APPLICATION

APPLICANTS DETAILS

Namecompany/institution/individual) , 6/Ae"l6 0 r,"* frW"U 5gAUIC€ -Sfflf ttS N

Person ' F1 (. Nr\-ftt q S,ut

elephone/Fax No. p=4 s3LToa O

Email ' SLe e @ l,vtstoc( *"^[tll"*- oJ nd*z"l^,eaulop,1,n^i{ .co.1

DEVELOPMENT DETAILS

Project Title/R*fogeD C-o,nSftLqCTto.t) aF lvDvr€ol,,E Qr.rro Se{Urc€ St4rrad@ff S * c.r a"reD / rvfftar S74a (rv fi-( t^t t flt t n) rv\ aE 0"4 L, al L t1 u ru n pq(,

Extent of Development Footprint (in m') 0,8 I-l-4

M ilrqs€-,

ryPES OF DOCUMENT

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FOR OFFICE USE ONLY

AMAFAID

FILEREF

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Co nS t a-.tc-( t aA a ? *D u'EOt^E (e |-lfftta^l q Qsscc,flrQ(N e{u+ <4e\.t cr,.t/t€ c6n0L-istNG df ft^eL Szw44,S

"4rWS t3 &t*g stnPn* n'Fr,,u ? yNl < t &n l, S qoh ('fttt L^'4s t+

1 ftt) ! rz'/ d EF, r( s flWafinnr1

l0?c<fed, c

d/SCOPING REPORT f/SCOPING REPORT

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EMP ROD

10 any development exceeding 5 000 m'in extent any other category ofdevelopment provided for inresulations

11 other activity which will change thecharacter of an area of land, or waterexceedins 10 000 m2 in extent

12 involving three or more existing erven

or subdivisions thereof13 any development, or other activity

involving three or more existing ervenor subdivisions

14 any development, or other activityinvolving three or more existing erven

or subdivisions which have beenconsolidated within the past five years

15 any development, or other activity thecosts ofwhich will exceed a sum set interms ofregulations

16 Rezoning of a site exceeding 10000 m'

fistrict Municipality I LE"we b rsr,crc r t-lr* \q pd.tLt rg

Nature of Development : (please tick the approprir AJ,I {

I construction of a road exceeding300 m in lensth

2 wall exceeding 300 m in length

J power line exceeding 300 m inleneth

4 pipeline exceeding 300 m in length

5 canal exceeding 300 m in length

6 other similar form of lineardevelopment

7 barrier exceeding 300 m in length

oo construction of a bridge exceeding50 m in leneth

o similar strucfure exceeding 50 m inlensth

Local Municipality ' nr$r."l6prr6 L"Cn L hr* r<firlLr

raditionatAuthoriry : nvl(q \b4rv) q 9c^rfr TrLqDrc t ,r\j qL Caq.vc t L

Area/Town : fvbr^Je D L"fe

ProperlyDescription ^Fn"nf? hsq l,uili,l B1 , Fqnn N,4W€K g S iS(Farm name, portion, lot, er$

South) Coordinate ,AaL1 3/ 02,0"

Coordinate 3l' oo' 16 .+3'

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BAR

:50000 mapsheet .

:10000 mapsheet '.

Nature of payment - postal order, bank deposit, internet banking: Bq*tt D*frs,, fr,,

Declaration

1, Nrurnuto SPezi undertake strictty to obserue the terms, conditions,restrictions, byJaws and directions under which the Council of Amafa aKwaZulu-Natali may issue the permit.

NB:

APPLICATIONS SUBMITTED WTH INCOMPLETE FORMS WLL NOT BE CONSIDERED

3HECKLIST YES NOCompleted & Signed Application Forms w-/Site Photographs \--"'1lq !q0 Topographicaland Aerial Photo Map t€PaymenU Proof of Payment \/

Signature @uar Place Dq&.&**tDate oq **t -Zaf V

Amafa Place

Date

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