DA Form 1

 ☐​ In a tidal area
 Name of local government for the tidal area ​(if applicable):​
 Name of port authority for tidal area ​(if applicable)​:
 ☐​ On airport land under the ​Airport Assets (Restructuring and Disposal) Act 2008
 Name of airport:
 ☐​ Listed on the Environmental Management Register (EMR) under the ​Environmental Protection Act 1994
 EMR site identification:
 ☐​ Listed on the Contaminated Land Register (CLR) under the ​Environmental Protection Act 1994
 CLR site identification:


 5) Are there any existing easements over the premises?
 Note: Easement uses vary throughout Queensland and are to be identified correctly and accurately. For further information on easements and
                                                   ​ A Forms Guide.
 how they may affect the proposed development, see D

 ☒​ Yes – All easement locations, types and dimensions are included in plans submitted with this development application
 ☐​ No


PART 3 – DEVELOPMENT DETAILS

Section 1 – Aspects of development
 6.1) Provide details about the first development aspect
 a) What is the type of development? ​(tick only one box)
 ☒ Material change of use             ☐​ Reconfiguring a lot                ☐​ Operational work                   ☐​ Building work
 b) What is the approval type? ​(tick only one box)
 ☒ Development permit                 ☐​ Preliminary approval               ☐​ Preliminary approval that includes a variation approval
 c) What is the level of assessment?
 ☒ Code assessment                    ☐​ Impact assessment ​(requires public notification)
 d) Provide a brief description of the proposal ​(e.g. 6 unit apartment building defined as multi-unit dwelling, reconfiguration of 1 lot into 3
    lots)​:
 Multiple Dwelling (3 units)
 e) Relevant plans
 Note:​ Relevant plans are required to be submitted for all aspects of this development application. For further information, see ​DA Forms guide:
        Relevant plans.
 ☒ Relevant plans of the proposed development are attached to the development application
 6.2) Provide details about the second development aspect
 a) What is the type of development? ​(tick only one box)
 ☐​ Material change of use            ☐​ Reconfiguring a lot                ☐​ Operational work                   ☐​ Building work
 b) What is the approval type? ​(tick only one box)
 ☐​ Development permit                ☐​ Preliminary approval               ☐​ Preliminary approval that includes a variation approval
 c) What is the level of assessment?
 ☐​ Code assessment                   ☐​ Impact assessment ​(requires public notification)
 d) Provide a brief description of the proposal ​(e.g. 6 unit apartment building defined as multi-unit dwelling, reconfiguration of 1 lot into 3
 lots)​:



 e) Relevant plans



                                                                                                                                            Page 3
                                                                                                         DA Form 1 – Development application details
                                                                                                                   Version 1.3— 28 September 2020