Development Application part 1 of 2 Application forms 1 & 5 & 8 - IDAS Checklist 1 & Part 2 - Covering Letter - Owners Consent - MCU12/0216

DDD
 Privacy -the information collected in this form will be used by the Department of Infrastructure and Planning (DIP)in
 accordance with the processing and assessment of your application. Your personal details will not be disclosed for a
 purpose outside of the IDAS process, except where required by legislation (including the Right to Information Act
 2009)or as required by Parliament. This information may be stored in a departmental database. The information
 collected will be retained as required by the Public Records Act 2002.


OFFICE USE ONLY



Date received
                I                             Reference numbers
                                                                      I
NOTIFICATION OF ENGAGEMENT OF A PRIVATE CERTIFIER



To:
                                                    I   Council. I have been engaged as the private certifier for the
                                                        building work referred to in this application.


Date of                                                                        BSA Certification       Building
                    Name
engagement                                                                     license number          classification/s




QLEAVE NOTIFICATION AND PAYMENT (for completion by assessment manager or private certifier if applicable)



                                                                                      Date receipted
                                        QLeave Project     Amount                     form sighted by Name of officer who
              Description of the work                                     Date paid
                                        Number             paid ($)                   assessment       sighted the form
                                                                                      manager



       11
The Sustainable Planning Act 2009 (SPA)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.




                                                                                             Application Details   -
                                                                                                                       IDAS form 1
                                                                                                Version 1.0 18 December 2009