Graffiti Removal Kit Application Form


Kempsey Shire Council – Your council Our community
Home General Info About us Attractions Climate Councillors & Directors Heritage General information FAQs Where to stay Tourist information Accommodation Holiday accomodation Beach resorts Holiday parks Conference venues Local media Public toilet website Rural villages How to get here Kempsey Kempsey history Flood warning terminology Organisation structure Photo galleries Statistics Community Aboriginal information Airlines Arts Mid North Coast Australia Day Awards Beachwatch monitoring Cemeteries Citizenship Community Art Gallery Community Directory Community Plans Community safety Events Events management Grant information Live Life Well Macleay Community Care Options Playgroups Project material Schools Communications Advertisements Agendas & minutes Comments & suggestions Community newsletters Council meetings Council Policies Customer Service requests Documents Documents on Public Exhibition Tenders Fact sheets Forms Local Government Elections 2008 From the Mayor's desk Media releases Positions vacant Useful web links Requests/complaints Statistics Water quality data Departments Corporate Services Customer First Centre Sustainable Environment General information Environment and Natural Resources Kempsey ESD Strategy Kempsey Local Environment Plan List of Development Control Plans Development Application Online Tracking and Public Register Development Applications proposed/approved Variations to Development Standards Register Joint Regional Planning Panels JRPP Agendas and Determinations Register of Council's Planning Decisions Political Donations and Gifts Register Human Resources Library Rates Shire services Tourism Water services Business & Industry Holiday Parks Conference venues Sustainable & Economic Development Industry Midwaste Real Estate Agents Saleyards Tell us your skills Services Emergency services Graffiti Blasters Midwaste Pay Rates online Rates information Road safety Swimming pools Water Services Waste management Weed control Works and Maintenance Youth services

GRAFFITI REMOVAL KIT APPLICATION

Council is making heavy duty and painted surface Graffiti Removal Kits available to residents as a proactive approach to reducing graffiti within the Shire.

To receive a Graffiti Removal Kit, applicants must complete this form and supply a clear photograph of the graffit. The graffiti must be located in the Kempsey Shire Council area.

Applicant Details

Name (required field):

Contact Person:

Address (required field):

Email:

Telephone (required field):

Mobile:

Location of Graffiti

Address of graffiti:

Type of structure:

Type of Kit

Place a tick in the box next to the type of kit you require:-

Heavy Duty Kit - for use on bare brick, stone and masonry surfaces.

Painted Surfaces Kit - for use on painted or sensitive surfaces such as painted walls, doors,
fences, gates, signs, posts, perspex, plastic playground equipment.

Photograph

I have supplied a digital photograph of the graffiti to be removed
(to attach photo CLICK HERE) OR

I will provide a photograph of the graffiti to be removed under separate cover.
(Mail to: Kempsey Shire Council, PO Box 3078, West Kempsey, Attention: Linda Young)

Privacy Statement

Council collects and holds personal information for a number of reasons related to Council business, eg to process applications, to issue rate notices, to process correspondence. When you provide personal information to Council it is used in accordance with privacy laws applicable to Council. Your personal information will only be used for purposes related to the business of Council.

Disclosure

The kit contents will only be used for their intended purpose as specified on the instruction sheet. Kempsey Shire Council holds no responsibility for damage or injury to any person or property. The kit will be used to remove graffiti within the Kempsey Shire Council area.

Applicant Consent

I agree, as the applicant, that I will abide by the above disclosure and any other conditions imposed by Council.

Click on "I Agree" button to confirm your agreement to the statement above and to submit your application.

Location: 22 Tozer Street Postal Address: PO Box 3078 WEST KEMPSEY NSW 2440	Customer Services: 02 6566 3200 Facsimile: 02 6566 3205 Email: ksc@kempsey.nsw.gov.au	Hours: 8.30 am to 4.30 pm Monday to Friday ABN 70 705 618 663
	This site is designed and maintained by Kempsey Council staff. Your questions and comments are most welcome. Please contact: ksc@kempsey.nsw.gov.au