07/0604 - Operational Works - Landscaping, Earthworks, Access & Frontage [As Published] · 142007.604

INTEGRATED PLANNING ACT 1997
Land owner's consent {if eppiicable)

Section 3.2.1(3) of the IPA prescribes that an
appfication must contain, or be supported by, the
written consent of the land owner's, if the application
involves:

() a material change of use;

i) reconfiguration of a let;

Gil), work on fand below high-water mark & not within a
canal as defined under the Coasta! Protection and
Management Act 1995;0r

(iv) work on rail corridor land defined under the
Transport Infrastructure Act 1994.

Section 3.8.1(2)(a) of the IPA provides that

Jandowner’s consent Is nof required for a mobile or

temporary ERA .

For more information refer to Guide 1,

20

Part A, Version 2.4, 29 May 2006
Land owner's consent to the making of this application:

 

 

Name Signature Date
() Thomas Muster Note: ownesS
of Consent not |!
nf OCOD
(iv)

 

  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Resource entitlement (if applicable) 21. Does this application involve a State resource prescribed under a regulation (other than involving
Pp!

Section 3.2.1(5) of the IPA requires evidence of quarry material on State coastal land under the Coastal Protection and Management Act 1995)?

resource entitlement be given for applications that

involve a prescribed State resource. X NO - go to Q24 O YES - go to Q22

Section 3.2.1(10)(a)(i) of the IPA prescribes that . ar . .

application pallid to be property ale 22. This application is accompanied by evidence: (tick applicable box)

vines evidence ee ee entidement C1 (i) of the allocation of, or entitlement to, the resource ~ attach evidence and go to Q23(vi)

Refer to schedule 10 of the Integrated Planning (1 (ii) the chief executive of the department administering the resource is satisfied the

Regulation 1998 that prescribes the nature of evidence development is consistent with an allocation of, or entitlement to, the resource - go

required by the State in support of the lodging af this to Q23 ae

development application,

D (ii) the chief executive of the department administering the resource is satisfied the
development application may proceed in the absence of an allocation of, or
entitlement to, the resource - go to Q23

Advice for completing Q23 23. Evidence of the resource entitlement:

The information in (i) - (v) is mandatory if evidence i : . . . Fr :

rea te OS i fa) aoe evtencos (i) Resource entitement / authority details (vii) Official stamp of the department
The official stamp af the Department of Natural administering the resource (if
Resources, Mines and Water is mandatory where the 7 applicable)

application involves any water or riverine quarry {ii) Name of delegated officer

material under the Water Act 2000.

Section 3,2.1(5A) allows the resoutoe manpet to limit

the time the evidence may be used. (vi) must be iii iti

completed if the evidence is time limited, (i) Ce ———— of delegated officer

(iv) Signature of delegated officer

(v) Date

(vi) pen date of evidence a

Assessment triggers 24. Is the IDAS Assessment Checklist completed and attached to this application?

This checklist does not apply if the application requires _ te i pe

the completion of Paris A and B of the Form only. It YES (NO - the assessment manager may refuse to accept this application on the
must be completed for all other applications. grounds that the application has not been properly made

Plans / drawings / reports 25. Plans/drawings/reports accompanying this application:

An application should be accompanied by details to
support the proposal & enable the assessment
manager, referral agencies and any person viewing
the application during public scrutiny or public
notification to understand the scope of the proposal
and any potential impact.

 

 

 

Plan { Drawing / Report Number Title Date
. Proposal Description (including | March
(i) 00656 LOS HB Proposal Plans) 2007

 

 

 

 

 

 

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

OFFICE USE ONLY (eppticable to assessment manager's)

FEE(S) DATE

RECENVED

32/alor | RECENING OFFICER'S IS See 7

REFERENCE
NUMBER/S

lof bey |