ESD Form

ENVIRONMENT SIGNIFICANCE DECLARATION AND PERMIT

Kia Orana

Any person, group or organisation that intends to carry out any activity that may impact the environment must fill out this declaration.

The checklist is used to identify physical, biological, social and economic factors, which might be changed by the proposal. Normally a background study will show those factors or issues that the proposal will or will not impact. A “YES” answer indicates further consideration to obtaining more information may be necessary. A “NO” answer in the second column indicates that the activity has no or low impact to the environment.

Under the Environment Act 2003 – Part 5, it is a requirement that all activities be assessed as to its potential impact upon the environment. Your cooperation in filling out this form will assist the National Environment Service in protecting our environment. Meitaki Maata.

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