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CERTIFICATE OF NOTIFICATION

I, the applicant: …………………………………………………………….…………………..……………


hereby certify that I have caused to be posted on the site situated
at………………………..…………………………...........................................................................
...................................... a plate notification for a proposed
………………….……………...………………..………………. as per specification of the local
authority since ………………………………...………….. I certify that such notice will be left
in position until the permit has been obtained.

Name of Applicant: ………………………………………………………

Signature: ……………………...…………………………………………

Date: ……………………………….

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