Application for a Permit for Berthing at Local Government Jetty

Please take the time to read through the Terms and Conditions before commencing your application.

This Permit is issued subject to the relevant provisions of the City of Busselton Jetties Local Law 2014, the City of Busselton Local Government Property Local Law 2010, the Terms and Conditions attached at “Annexure A”, all relevant information provided by the Applicant in the applicable application form and the terms and conditions contained herein.

The Permit Holder acknowledges and admits that they have read and fully understands the meaning and legal consequences of the relevant provisions of the Property Local Law and the terms and conditions contained herein and covenants and agrees to be bound by and fully comply with them.

Terms and Conditions for Use of Local Government Jetty

Please click on the link below to read the Terms and Conditions.

Terms and Conditions for Use of Local Government Jetty

Jetty Berthing Map

Primary Tender Platform (East)

Primary Tender Platform - East

Secondary Tender Platform (West)

Secondary Tender Platform (West)

Fees

Please refer to the City of Busselton Fees and Charges "Commercial Use of Marine Berthing Platforms - Whale Watching/ Tour Vessel-Per Vessel" for up to date list of applicable fees.

Refundable bond charge per vessel will also need to be paid in advance.

Fees and Charges

Name of Applicant*

Name of Representative (if Applicant is a corporation, incorporated association or other juristic entity)

Applicant ABN*

GST REG

Yes
No

Business Address (street address)*

Postal Address (if different to above)

Phone Number*

Mobile

Email Address*

Contact Details of Responsible Adult Person during the Vessels Berthing

(Please note that for the term of the permit, this person is to be contactable at any time of the day or night and will respond, within a reasonable time, to requests related to vessels and berthing)

Full Name*

Mobile Phone Number*

Email Address*

Permit Particulars

Commencement Date

End Date

Days of use

Hours of Use (Vessels are to berthed only for the period of time needed for loading/unloading passengers, up to a maximum of 30 minutes at a time unless otherwise approved by the City)

Details of Berthing Location

Please select only one berthing location (to view a map of the location, please scroll to the top of the form and click on the Map dropdown)*

Western Platform
Eastern Platform
Alley's Landing

Purpose for which the Jetty is proposed to be used? (eg, berthing of tender vessels used for passenger transfer to and from the mainland)*

Berthing Vessel Information

Name and Number of Vessel*

Length of Vessel*

Gross Weight of Vessel*

Draft of Vessel

Passenger Capacity*

Method of Securing Berthed Vessel

As per clause 17 of the above Terms and Conditions, the applicant must provide sufficient detail to demonstrate to the City of Busselton satisfaction that mooring methodology will meet relevant industry standards.*

Information for Approval (must be uploaded with application)

Public Liability Insurance - $10 million in respect of any one claim*

Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx

Damage to Local Government Property - $1 million in respect of any one claim (if not covered under public liability insurance)

Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx

Workers Compensation (as required by law)

Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx

Safety Management Plan*

Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx

Declaration

I Acknowledge and Declare that I am duly authorised to make this application on behalf of the Applicant*

Yes

I Acknowledge and Declare that the information provided in respect of this application is to my best knowledge true and correct*

Yes

I have read the Terms and Conditions (above) and agree on behalf of the applicant*

Yes

I Acknowledge and Declare that provision of false or incorrect information may cause summarily cancellation of any permit granted in terms hereof.*

Yes

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