07/0521 - Completed IDAS form Part N as requested [As Published] · 132007.521

INTEGRATED PLANNING ACT 1997 Part N, Version 1.0, 4 October 2004

     
 

Re oe ee

Contaminated land

 

Completion of all questions on Part N is mandatory for all applications involving assessment against the Environmental Protection Act 1994 when
development is proposed on contaminated or potentially contaminated land.
For further information refer to Guide 5 Contaminated land matters available free from www.ipa.qld.qov.au or the Environmental Protection Agency's
(EPA's) information sheets available free from www.epa.qid.qov.au under Ecoaccess/ business and industry. Alternatively, contact the local government.

 

 

 

 

 

 

 

 

 

 

 

Nature of the application 4. This application is for: (Tick one (1) or both if applicable)
Exempti to 1.
Refer ip Guile Coo ted eed sitrs Aspect of development Type of approval being sort
for advice regarding development that is 7 — 7
exempt from thls assessable development LX) Material change of use &] Preliminary approvat C2 Development permit
trigger.
CD Reconfiguring a lot (] Preliminary approval _|[_] Development permit
2. Does this application require assessment against a planning scheme?
Ono [Xd YES - complete other relevant parts of the IDAS Application Form 1
The subject land 3. Has an Environmental Management Register (EMR) and/or Contaminated Land Register (CLR)
search been conducted for the land the subject of the application?
INO (C1YES - attach resuts of the search and complete Q4

4. All or part of the land the subject of the application is:
oO (i) on the EMR or the CLR under the Environmental Protection Act 1994;

(C2) (ii) used for, or if the land is vacant, was last used for-
O(a) anotifiable activity
(7)(b) _ an industrial activity and the proposed use is for a child care centre,

educational, recreational or residential purpose (including a caretaker residence on
industrial land);

(-] (iti) in an area for which an area management advice has been given for natural
mineralisation or industrial activity and the proposed use is for child care, educational,
recreational or residential purpose (including e caretaker residence on industrial land);

EX] (iv) in an area for which an area management advice has been given for unexploded

 

ordnance.
Plans and documents 5. Confirm, by ticking the applicable box(es), that the following details are provided in plans and
For further information about preparing a written information supporting this application:
oronosa iio refer to Guide 7 Preparing a (1 (i) plans showing where any Notifiable Activity, Hazardous Contaminant, or potentially

contaminated activity / activities have occurred on site;

(ii) _ if the application involves a matesial change of use from an industrial use to a more
sensitive use (eg. child care, educational, recreational or residential purposes), Supply a detailed
site history outlining previous potentially contaminated uses on the site

PLEASE NOTE
PART N of Form 4 cannot be accepted by the assessment manger unless accompanied by PART A of Form 1.

The assessment manager may refuse to accept an application that, at the time of lodgement, fails to provide all applicable information
requested by Part A and any other relevant part of Form 1.

 

 

 

OFFICE USE ONLY (applicable fo assessment manager)

REFERENCE
DATE RECEIVED NUMBERIS