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

                                                                          Department of Infrastructure, Local Government and Planning




Question 12
• The portable long service leave levy need not be paid when the application is made, but the Building and
   Construction Industry (Portable Long Service Leave) Act 1991 requires the levy to be paid before a development
   permit is issued.
• Building and construction industry notification and payment forms are available from any Queensland post office or
  agency, on request from QLeave, or can be completed on the QLeave website at www.qleave.qld.gov.au.        For
  further information contact QLeave on 1800803481 or visit www.qleave.qld.gov.au.


Privacy-The    information collected in this form will be used by the Department of Infrastructure, Local Government
and Planning (DILGP), assessment manager, referral agency andlor building certifier in accordance with the
processing and assessment of your application. Your personal details should not be disclosed for a purpose outside of
the IDAS process or the provisions about public access to planning and development information in the Sustainable
Planning Act 2009, except where required by legislation (including the Right to Information Act 2009) or as required by
Parliament. This information may be stored in relevant databases. The information collected will be retained as
required by the Public Records Act 2002.



OFFICE USE ONLY

 Date received     ___________                           1   Reference numbers

NOTIFICATION     OF ENGAGEMENT               OF A PRIVATE CERTIFIER

 To                                                          Council. I have been engaged as the private certifier for the

        --------------- I
                                                             building work referred to in this application

                                                                            BSA Certification license         Building
 Date of engagement              Name
                                                                            number                            classificationls




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

                                                                                            Date receipted
                                                                                                                 Name of officer
                                        QLeave project   Amount paid                        form sighted by
 Description of the work                                                       Date paid                         who sighted the
                                        number           ($)                                assessment
                                                                                                                 form
                                                                                            manaoer




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




                                                                                                    IDAS form 1-Application details
                                                                                                        Version 4.2-3 August 2015