(this part should be completed by the Occupant of the property.)
| Name of Occupant | |
| e-mail address | |
| Address of property | |
| Full details of request (if necessary append a sketch or plan as an attached page) | |
| Requested completion/delivery date | |
| Justification of above date | |
| Signature of Occupant | Date |
(this part to be filled in by the Housing Officer)
Please mark one of a,b or c and then the signature and date
| a) Approved | ||
| b) Not Approved | ||
| Reason | ||
| c) Referred to Housing Committee | ||
| Date of next meeting | ||
If you selected a) (approved) above then complete one of the options f,g or h below
| f) If to be done by Office | ||
| Estimated completion date: | ||
| g) If to be done by Maintenance staff, | ||
| date referred: | ||
| h) If to be done by Occupant, | ||
| Maximum cost allowed: | ||
| Shop at which to obtain Observatory discount: | ||
| Signature of Housing Officer | Date | |
(this part should be completed by Housing Committe if referred.)
please complete one of the two alternatives
| If approved | |
| estimated completion date: | |
| If NOT approved | |
| reason: | |
| Signature for Housing Committee | |
| Date | |