10/0627 - Lot Reconfiguration (1 lot into 3) [As Published] · 152010.627

 

 
 

 

 

1andatory. supporting ink his application. 7

 

 

 

 

Plans Confirmation of
lodgement Method of lodgement
plans showing where any notifiable activities, hazardous contaminant or BJconfirmed over the counter

potentially contaminated activity has occurred on the premises

 

Written documentation

 

if the application involves a material change of use from an industrial use |["}confirmed
to a more sensitive use (e.g. child care, educational, recreational or
residential purposes), then a detailed site history outlining previous
potentially contaminated uses on the premises [X]not applicable

 

 

 

 

 

Privacy - please refer to your assessment manager for further details on the use of information recorded in
‘this form.

OFFICE USE ONLY

 

 

Date Received Reference Numbers

 

 

 

 

 

 

The Sustainable Planning Act 2009 is administered by the Department of Infrastructure and Planning. This form and
all other required application materials should be sent to your assessment manager and any referral agencies.

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Contaminated fand - IDAS form 24
Version 1.0 18 December 2009