Private works request form

Got private works that you would like completed by the Shire? 

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Below you will find the current fees & charges for private works, if you require some work to be completed, upon completing this form a staff member will be in contact to arrange these works and give you a time frame. On completion of works, you will be invoiced by the shire and a invoice sent to the address completed below. 

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By completing this form you hereby agree to pay all costs and charges imposed by the Shire of Dumbleyung in undertaking the private works as listed below, and to be responsible for the payment of any account rendered by it. It is acknowledged that I/we shall not hold the Shire responsible for any loss or damage of any nature caused by the Shire or its workmen, agents or equipment in the carrying out of the works set herein, and shall hold the Shire indemnified against any action claim suit or proceeding by any person arising out of the works herein.

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Details of Private Works Request