MCU16/0036 Development application - 52 Gevers Rd, Black Mountain

                                                                      Department of Infrastructure,    Local Government and Planning




Email address (non-mandatory     requirement)       [email protected]



Applicant's reference number (non-mandatory
requirement)

1.    What is the nature of the development       proposed    and what type of approval        is being sought?

Table A-Aspect     1 of the application (If there are additional aspects to the application please list in Table B-Aspect        2.)

a)   What is the nature of the development?     (Please only tick one box.)

     [8JMaterial change of use       0 Reconfiguring a lot           0 Building work                   0 Operational work
b)   What is the approval type? (Please only tick one box.)

     o   Preliminary approval
          under s241 of SPA
                                     o Preliminary approval
                                           under s241 and s242
                                                                     0 Development permit
                                           of SPA
c)   Provide a brief description of the proposal, including use definition and number of buildings or structures where
     applicable (e.g. six unit apartment building defined as a multi-unit dwelling, 30 lot residential subdivision etc.)

     Build a relatives dwelling more than 25 metres from the existing dwelling and build a studio/storage          building
           more than 25 metres from the existing dwelling.


d)   What is the level of assessment? (Please only tick one box.)

     o Impact assessment             ~    Code assessment


Table B-Aspect    2 of the application (If there are additional aspects to the application please list in Table C-
Additional aspects of the application.)

a)   What is the nature of development? (Please only tick one box.)

     o Material change of use        0 Reconfiguring a lot           [8J Building work                 0 Operational work
b)   What is the approval type? (Please only tick one box.)

     o Preliminary approval          o Preliminary approval          o Development
          under s241 of SPA                under s241 and s242             permit
                                           of SPA
c)   Provide a brief description of the proposal. including use definition and number of buildings or structures where                  •
     applicable (e.g. six unit apartment building defined as a multi-unit dwelling, 30 lot residential subdivision etc.)

     Build a relatives dwelling and studio/storage shed.



d)   What is the level of assessment?

     o   Impact assessment           0 Code assessment
Table C-Additional   aspects of the application (If there are additional aspects to the application please list in a
separate table on an extra page and attach to this form.)

     o Refer attached schedule       [8J Not required


                                                                                                      /DAS form l-Applicalion details
                                                                                                          Version 4.2-3 August 2015