APPENDIX IV - Forms under Chapter IV. WATER RESOURCES DEVELOPMENT AND FLOOD CONTROL

2. GOVERNMENTAL CONTROL OF WATER DEVELOPMENT WORKS AND STRUCTURES

V - UGANDA - Water Resources Regulations, 1998

SIXTH SCHEDULE
THE REPUBLIC OF UGANDA
THE WATER STATUTE, 1995
The Water Resources Regulations, 1998

FORM F1.

Regulation 16 (2)

APPLICATION FOR A CONSTRUCTION PERMIT
To be completed in triplicate (3)

1. NAMES AND ADDRESSES
Names of Company/Cooperative Society/Public Corporation/Partnership*...............
Address:.......................................................................................................................
Telephone:...................................................................................................................
Designation:.................................................................................................................
Acting for Company/Partnership/Public Corporation/NGO/Cooperative Society*
Postal address (if different from above):.....................................................................
District:........................................................................................................................
Main Activity:..............................................................................................................
*Delete what is not applicable.

2. COMPANY/CO-OPERATIVE SOCIETY/PUBLIC CORPORATION/PARTNERSHIP NAME

Will you work for a company under your permit?

() Yes

() No

If Yes, please give the name, address, registered number and trading licence of that company:
Name:..........................................................................................................................
Address:.......................................................................................................................
Date of registration:.....................................................................................................
Trading Licence No:....................................................................................................

3. EQUIPMENT

List the relevant construction equipment and vehicles possessed by you or your employer. Attach an extra sheet of paper if necessary.

4. STAFF

Give brief details of the name, age, relevant qualifications and experience of any people employed by you or the company, who will work on construction under the permit.

5. YOUR EXPERIENCE

What formal qualifications do you have to undertake a construction work:?.............
......................................................................................................................................
......................................................................................................................................
Give details of any previous construction permit which yuu have held:.....................
......................................................................................................................................
......................................................................................................................................
Give the following details about any construction work you have previously
undertaken: Client name:.............................................................................................
......................................................................................................................................
Description of work:....................................................................................................
......................................................................................................................................
Date of work:...............................................................................................................
......................................................................................................................................

6. FURTHER RELEVANT INFORMATION

Attach any other relevant information to the one already specified

DECLARATION OF THE APPLICANT

I certify that the information provided in this form is correct to the best of my knowledge. I also agree that no decision will be made nor action taken with respect to this application until I receive a notification from the Directorate of Water Resources that I have provided all the necessary information.

Signature of applicant	Official seal/stamp
Full names _____________________	Date: _________________________

NOTE

When you have completed this form and the appropriate attachments, you must attach CASH or CHEQUE for Ushs. for processing the application and send them to:

The Director
Directorate of Water Resources
P.O. Box 20026
Kampala

The Director may require you to advertise this application at your cost in a way specified by the Director.

OFFICIAL USE ONLY

RECEPTION DATE: (D) ____________ (M) ____________ (Y) _____________
APPLICATION NUMBER ___________________________________________

SIXTH SCHEDULE
THE REPUBLIC OF UGANDA
THE WATER STATUTE, 1995
The Water Resources Regulations, 1998

FORM F3

Regulation 19 (1) and (2)

CONSTRUCTION PERMIT
To be completed in triplicate (3)

Permit No.....................................................................................................................
Name and Address.......................................................................................................
......................................................................................................................................
You are hereby authorised to carry out the following works:.....................................
Location (District, County, Sub-county, Parish, Villages, Volume/Block, Folio
Number/Plot Number):................................................................................................
......................................................................................................................................
This permit shall be valid from (date) to (date)...........................................................
In addition to the extra conditions specified in these regulations and other law in
force, this permit is subject to the following conditions:
1...................................................................................................................................
2...................................................................................................................................
3...................................................................................................................................
4...................................................................................................................................
5...................................................................................................................................
6...................................................................................................................................

Date:...............................................	...............................................
	Signature
Official Stamp
	...............................................
	Name Director of Water Resources

VI - AUSTRALIA - NORTHERN TERRITORY - Water Regulations, 1999

FORM 6

Regulation 6(1)

NORTHERN TERRITORY OF AUSTRALIA
Water Regulations

APPLICATION FOR A PERMIT TO CONSTRUCT OR ALTER WORKS
Pursuant to section 41 of the Water Act
Application No......... (office use only)

1. GENERAL

Name of Applicant:......................................................................................................
	(surname)		(given names)
Postal Address:.............................................................................................................
Post Code..........................................		Phone No................................................

2. PROPERTY DETAILS

(a) Details of property on which construction or alteration will occur -

Lot....... Section No........ Hundred of...................................................................
Portion No......... Township...................................................................................
Lease No/name.......................................................................................................
(b) Nature of applicant's interest in the land on which construction or alterations will occur is as *owner/*occupier/*lessee of the property.

3. DETAILS OF PROPOSED CONSTRUCTION OR ALTERATION

		(a) The proposed works are --
			(i) New works (ii) Alteration to existing works, dam or water storage (iii) Other. Give details
.................................................................................
	(b) As an attachment to this application, describe the proposed construction of or alterations to works, including the size (significant and principal dimensions of structure or influence on locality, attach appropriate plans and drawings), method of construction, supervision, duration of construction or alteration and any ongoing maintenance works. (c) As an attachment to this application, provide a map showing the location of the proposed works in relation to the water course and lands in the immediate vicinity.
	(d) Previous Permit number (if applicable)............................................................
								Yes	No
		(e) Is the purpose of the works to enable water to be taken from the water course?
				(i) If yes, is it proposed to take water for
					- Domestic purposes - Stock grazing - Irrigation areas larger that 0.5 hectares. Please indicate area and likely crops to be grown.
						Type	Hectares
						.............	..............
					- Other. Give details
					...................................
				(ii) If no, describe the purpose.
					............................................

Note: A Permit to Construct or Alter Works does not guarantee the right to extract water for other than basic stock and domestic purposes.

A Licence to Take or Use Surface Water may be necessary, particularly where larger volumes are involved.

NOTE: ADVERTISING OF APPLICATION

The Controller of Water Resources may give notice of this application to those likely to be affected by its approval.

Signing of this application approves the advertising by the Controller of this application in one edition of a newspaper circulating generally in the locality of the proposed works.

Applicant's Signature..............................
Date:........................................................

To: The Controller of Water Resources
(address)
* delete as necessary

FORM 7

Regulation 6(2)

NORTHERN TERRITORY OF AUSTRALIA
Water Regulations

NOTICE OF APPLICATION
Pursuant to section 41 of the Water Act

I,.................................................................................................................................
	(the Controller)
hereby give notice of an application for a Permit under section 41 of the Water Act to construct/alter the following works
....................................................................................................................................
	(description of works)
on land situate at........................................................................................................
	(description of land)
Any enquiries concerning this application should be directed to(name of person).
Any objection to the issue of a Permit authorising the proposed works must be forwarded in writing to reach me at (address), within 30 days of the date hereof.
Dated:
		Controller of Water Resources
	____	_________________________

FORM 8

Regulation 6(4)

NORTHERN TERRITORY OF AUSTRALIA
Water Regulations

PERMIT TO CONSTRUCT OR ALTER WORKS
Pursuant to section 41 of the Water Act
Permit No......

Subject to full compliance with the terms and conditions set out below, permission
is granted to...............................................................................................................
of...............................................................................................................................
to undertake the following work...............................................................................
on the........................................................................................................................
(name the watercourse)
located at Lot..................... Section No................. Hundred of...............................
Portion No........................................ Township......................................................
Lease No./name........................................................................................................
Such work must be completed within 12 months of the date from this Permit.

Terms and Conditions

1. Strict compliance with any ongoing maintenance or operational requirements set out in Condition No. 5 hereunder will be required both during and after completion of construction or alteration of the works.

2. The location of the works constructed or altered in pursuance of this Permit shall be in accordance with the plan provided with this Permit.

3. Where the works constructed/altered in pursuance of this Permit shall be capable of retaining diverting or conserving water, the permittee shall not take or divert any water except in accordance with the Water Act.

4. The permittee shall not alter any works constructed in pursuance of this Permit except in accordance with the terms of a further Permit.

5. The following specific conditions will apply -

Controller of Water Resources
Date ____________________

Note: Every application for a reissue of a Permit shall be made not later than one calendar month prior to the date of expiry of this Permit.

XI - CANADA - BRITISH COLUMBIA - Dam Safety Regulation, 2000

Schedule 1

(sections 2 (1) (d) and 3 (2))

Downstream Consequence Classification Guide

Rating	Loss of Life	Economic and Social Loss	Environmental and Cultural Losses
VERY HIGH	Large potential for multiple loss of life involving residents and working, travelling and/or recreating public. Development within inundation area (the area that could be flooded if the dam fails) typically includes communities, extensive commercial and work areas, main highways, railways, and locations of concentrated recreational activity. Estimated fatalities could exceed 100.	Very high economic losses affecting infrastructure, public and commercial facilities in and beyond inundation area. Typically includes destruction of or extensive damage to large residential areas, concentrated commercial land uses, highways, railways, power lines, pipelines and other utilities. Estimated direct and indirect (interruption of service) costs could exceed $100 million.	Loss or significant deterioration of nationally or provincially important fisheries habitat (including water quality), wildlife habitat, rare and/or endangered species, unique landscapes or sites of cultural significance. Feasibility and/or practicality of restoration and/or compensation is low.
HIGH	Some potential for multiple loss of life involving residents, and working, travelling and/or recreating public. Development within inundation area typically includes highways and railways, commercial and work areas, locations of concentrated recreational activity and scattered residences. Estimated fatalities less than 100.	Substantial economic losses affecting infrastructure, public and commercial facilities in and beyond inundation area. Typically includes destruction of or extensive damage to concentrated commercial land uses, highways, railways, power lines, pipelines and other utilities. Scattered residences may be destroyed or severely damaged. Estimated direct and indirect (interruption of service) costs could exceed $1 million.	Loss or significant deterioration of nationally or provincially important fisheries habitat (including water quality), wildlife habitat, rare and/or endangered species, unique landscapes or sites of cultural significance. Feasibility and practicality of restoration and/or compensation is high.
LOW	Low potential for multiple loss of life. Inundation area is typically undeveloped except for minor roads, temporarily inhabited or non- residential farms and rural activities. There must be a reliable element of natural warning if larger development exists.	Low economic losses to limited infrastructure, public and commercial activities. Estimated direct and indirect (interruption of service) costs could exceed $100 000.	Loss or significant deterioration of regionally important fisheries habitat (including water quality), wildlife habitat, rare and endangered species, unique landscapes or sites of cultural significance. Feasibility and practicality of restoration and/or compensation is high. Includes situations where recovery would occur with time without restoration.
VERY LOW	Minimal potential for any loss of life. The inundation area is typically undeveloped.	Minimal economic losses typically limited to owner's property not to exceed $100 000. Virtually no potential exists for future development of other land uses within the foreseeable future.	No significant loss or deterioration of fisheries habitat, wildlife habitat, rare or endangered species, unique landscapes or sites of cultural significance.

Schedule 2

(sections 5 (a) and 7 (1))

Minimum Inspection Frequency and Dam Safety Review Requirements

Item	Very High Consequence	High Consequence	Low Consequence	Very Low Consequence
Site Surveillance (a)	WEEKLY	WEEKLY	MONTHLY	QUARTERLY
Formal Inspection (b)	SEMI-ANNUALLY	SEMI-ANNUALLY or ANNUALLY	ANNUALLY	ANNUALLY
Instrumentation	AS PER OMS * MANUAL	AS PER OMS *MANUAL	AS PER OMS * MANUAL	N/A
Test Operation of Outlet Facilities, Spillway Gates and other Mechanical Components	ANNUALLY	ANNUALLY	ANNUALLY	ANNUALLY
Emergency Preparedness Plan	UPDATE COMMUNI-CATIONS DIRECTORY SEMI-ANNUALLY	UPDATE COMMUNI-CATIONS DIRECTORY SEMI-ANNUALLY	UPDATE COMMUNI-CATIONS DIRECTORY ANNUALLY	N/A
Operation, Maintenance & Surveillance Plan	REVIEW EVERY 7 - 10 YEARS	REVIEW EVERY 10 YEARS	REVIEW EVERY 10 YEARS	REVIEW EVERY 10 YEARS
Dam Safety Review (c)	EVERY 7-10 YEARS (d)	EVERY 10 YEARS (d)	(d)	(d)

* Operation, Maintenance, and Surveillance Manual.

(a) Site surveillance may consist of visual inspections and/or monitoring of automated data acquisition systems. Reduced frequencies of visual inspections may be determined by seasonal conditions.

(b) Formal Inspections are intended as more thorough inspections performed by the appropriate representative of the owner responsible for safety surveillance.

(c) A Dam Safety Review involves collection of all available dam records, field inspections, detailed investigations and possibly laboratory testing. It then proceeds with a check of structural stability and operational safety of the dam, beginning with a reappraisal of basic features and assumptions. The level of detail required in a Dam Safety Review should be commensurate with the importance and complexity of the dam, as well as the consequences of failure.

(d) Dam owners must conduct an annual review of conditions downstream of their dam and notify a dam safety officer if the downstream consequence classification level increases. The downstream consequence classification guide is shown in Schedule 1.