Development Application - Part 1 of 2 - IDAS Forms 1 & 6 and Checklist 1 - OPW12/0432

12. Does the proposal include new building work or operational work onthe premises? (inCluding any
       ’services)

D No r;g] Yes          -
                           ensure the nature, location and dimensions of   proposed works are included in plans submitted

13. Is the payment of a portable long service leave levy applicable to this application? (refer to the notes at the
       end of this form for more information)


r;g] No    -
               Go to question 15                  DYes


15. Has the local government agreed to apply a superseded planning scheme to this application under
                                                                                                                             .




       section 96 of the Sustainable Planning Act 2009?



r;g]    No

DYes provide details below
               -




16. List below all of the forms and supporting information that accompany this application (include alllDAS
forms,4checklists, mandatory supporting in1ormation etc. that will be submitted as part of this application. Note: this
question does not apply for applications m de online using Smart eDA)

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


                   1   Form 6                                                                         over the counter




                   2   Checklist                                                                      over the counter




                   3   John Norden Plans                                                              over the counter




117. pplicant’s declaration
 rv’I     By making this application, I declare that all information in this application is true and correct (note: it is
 l6I      unlawful to provide false or misleading information).




                                                                                                  Application Details   -
                                                                                                                            IDAS form 1
                                                                                                    Version 1.0 18 December 2009