10/0662 - Operational Works [As Published] · 142010.662

LIL

 

42° Doed the proposal include new building work or operational work on the premises? (including any
services)

 

 

BJNo [_] 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)

 

(| No - Go to question 15 x] Yes

 

14. Has the portable long service leave levy been paid? (refer to notes at the end of this form for more
information)

 

 

 

{x} No

complete table K and submit with this application the yellow jocal government/ private certifier's copy of
the receipted QLeave Form

CI] Yes -

 

15. Has the local government agreed to apply a superseded planning scheme to this application under
section 96 of the Sustainable Planning Act 20097

 

 

 

— No

LL] Yes - provide details below

 

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

 

 

Method of lodgement to

Description of attachment or title of attachment assessment manager

 

 

 

 

 

 

 

17. Applicant's declaration

 

 

By making this application, | declare that all information in this application is true and correct (note: it is
unlawful to provide false or misleading information).

 

 

 

Application Details - IDAS form 1
Version 1.0 18 December 2009

 

.