Development Application for permit to damage vegetation - OPW13/0600

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12. Is the payment of a portable I ong service Ilia
                                                                 ,


                                                                  plit~b  .N
                                                                               e to this   applica,tion’?:(Ref r,to notes at the end
                                                                      ,



of this form for more   informatio~.)

D    No-go to question 14               DYes

13. Has the portable long service leave l Vy been paid? (R           I~r;to notes ;;~t the end of this form for more
information.)


D     No


D     Yes-complete Table Nand submit with this application the yellow local governmenUprivate certifier’s copy of the
      receipted OLeave form

Table N


                                          OLeave project number (6 digit numb                  starting with A, B, E, Lor P)
                                                                                                                                    .




Amount paid               Date paid                                                        r


                          (dd/mm/yy)




                                                                                                                       .’.A.
14. Has the local   governmi~ntagreed to apply      a su                   n    i~g s,cheme to this appl"t’"g                  under section
                                                                                                                               w


96 of the Sustainable Planning A ct2009?



D     No


D     Yes-please provide details b elow


Name of local government                          Date of written notice given         Reference number of written notice given
                                                  by local government                  by local government (if applicable)
                                                  (dd/mm/yy)




 15. List below all of the forms an d supporting information thi’lt accompany this application (Include alllOAS,
 forms, checklists, mandatory supporting information etc. th        ~!Jl?fnitt~d as part of this application. N te: this
                                                                t;,~ill bE:)
 question  does not apply for applicalions made online using S       A )!nt
                                                                    ~art:

Description of attachment or title of attachment                                                      Method of lodgement to
                                                                                                      assessment manager




                                                                                                     ,;’   .,




 16. Applicant’s declaration



 D By making this application, Ideelare that all information in this application is true and correct (Note:it is unlawful to
 provide false or misleading information.)




6                                                                                                               IDAS form 1-Appfication details
                                                                                                                 Version 2.0 17 December 2012