Municipal Heritage Inventory - Application for Deletion Form

Please note, an * indicates a mandatory field.
Please be sure to fill in all mandatory fields.
Telephone numbers are required to be numbers only with no spaces, letters or characters e.g. 92736000.

MHI - Application for Deletion Form
Contact Details
Name: *
Address:
Telephone:
Email Address: *
The Place to be considered for Deletion
Name of Place (if any):
Address / Location: *
Suburb: *
Supporting Evidence
With reference to the Place Record Form for the subject place, on what grounds do you think that it should be considered for deletion from the MHI (in your opinion)? (e.g. Inaccurate statement of significance provided, unrecognised alterations and addition as to the existing significant fabric, inaccurate physical description, inaccurate historical background etc): *
References (e.g. books, historical photographs, certificate of title, maps, sewerage plans, postal directory, correspondence, newspaper articles etc):
Other Comments:
Please upload any related documents/photographs (if more than one is necessary you can compress these into a zip file. For help on how to do this please Click Here):