Victorian Consolidated Regulations

HERITAGE (UNDERWATER CULTURAL HERITAGE) REGULATIONS 2017 - SCHEDULE 1

Schedule 1—Form for exploration or recovery of registered shipwrecks, historic shipwrecks, registered shipwreck artefacts or historic shipwreck artefacts and in relation to protected zones

Regulation 5

    1.     Applicant details

Title:

First name:

Surname:

Address:

Email address:

Telephone:

Is this application on behalf of a company or organisation? *Yes/*No

What is its name?

What is your position title?

    2.     Details of registered shipwreck, historic shipwreck, registered shipwreck artefact or historic shipwreck artefact

Name of shipwreck or artefact:

Location (if known):

Victorian Heritage Register number (if known):

Description of shipwreck or artefact:

    3.     Details of vessel(s) involved with the activity

Vessel name(s):

Registration number(s):

Vessel contact details (phone, radio call sign and frequency):

Name(s) of boat operator:

    4.     Permit type

Tick boxes as applicable:

≤     To enter a protected zone and undertake recreational diving or snorkelling.

≤     To enter a protected zone and undertake recreational diving or snorkelling and require the use of moorings.

≤     For commercial operator to enter a protected zone and undertake recreational diving or snorkelling on one occasion.

≤     For commercial operator to enter a protected zone and undertake recreational diving or snorkelling on up to a maximum of 5 occasions.

≤     To enter a protected zone for other purposes.

≤     To enter a protected zone for other purposes and require the use of moorings.

≤     To recover registered shipwreck artefacts or historic shipwreck artefacts.

≤     To disturb a registered shipwreck, historic shipwreck, registered shipwreck artefact or historic shipwreck artefact.

≤     Other [ please state ]:

    5.     Details of the activities to be undertaken

Summary of activity:

Proposed date(s) of activity:

Names of divers:

    6.     Permit fee

Fee to be paid:

Note:     If these activities are being undertaken by a community group or for conservation, educational research or public safety, it may be possible to apply for a waiver of the permit fee. Please consult Heritage Victoria in relation to your application.

Note:     If this application relates to a registered place of which you are the owner and which is your principal place of residence, or to a registered object which you own, and you hold one of the following cards or have been declared a class or classes of eligible person by Order published under the State Concessions Act 2004 in the Government Gazette, you are exempt from paying this fee. Please provide copies of the relevant card and either your driver's licence or a current rates notice for your principal place of residence to confirm your eligibility:

              •     Health care card issued under section 1061ZS of the Social Security Act 1991 of the Commonwealth other than in respect of a child in foster care, or a child in respect of whom a carer allowance under section 953 of that Act is payable; or

              •     Gold Card issued in respect of Part V of the  Veterans' Entitlements Act 1986 of the Commonwealth other than a dependant (not including the widow or widower) of a veteran; or

              •     Pensioner concession card issued under section 1061ZF of the Social Security Act 1991 of the Commonwealth.

    7.     Payment options
    8.     Applicant statement

I state that the information I have given on this form is correct to the best of my knowledge.

Name:

Signature:

Date:

*delete if not applicable