DA Form 1

   Yes – the ‘Notice Accepting a Failure Impact Assessment’ from the chief executive administering the Water
 Supply Act is attached to this development application
   No
 Note: See guidance materials at www.dnrme.qld.gov.au for further information.

 Tidal work or development within a coastal management district
 23.12) Does this development application involve tidal work or development in a coastal management district?
     Yes – the following is included with this development application:
          Evidence the proposal meets the code for assessable development that is prescribed tidal work (only required
        if application involves prescribed tidal work)
            A certificate of title
     No
 Note: See guidance materials at www.des.qld.gov.au for further information.
 Queensland and local heritage places
 23.13) Does this development application propose development on or adjoining a place entered in the Queensland
 heritage register or on a place entered in a local government’s Local Heritage Register?
     Yes – details of the heritage place are provided in the table below
     No
 Note: See guidance materials at www.des.qld.gov.au for information requirements regarding development of Queensland heritage places.

 Name of the heritage place:                                                        Place ID:
 Brothels
 23.14) Does this development application involve a material change of use for a brothel?
    Yes – this development application demonstrates how the proposal meets the code for a development
 application for a brothel under Schedule 3 of the Prostitution Regulation 2014
    No
 Decision under section 62 of the Transport Infrastructure Act 1994
 23.15) Does this development application involve new or changed access to a state-controlled road?
     Yes - this application will be taken to be an application for a decision under section 62 of the Transport
 Infrastructure Act 1994 (subject to the conditions in section 75 of the Transport Infrastructure Act 1994 being
 satisfied)
     No


PART 8 – CHECKLIST AND APPLICANT DECLARATION
 24) Development application checklist
 I have identified the assessment manager in question 15 and all relevant referral
 requirement(s) in question 17                                                                                           Yes
 Note: See the Planning Regulation 2017 for referral requirements
 If building work is associated with the proposed development, Parts 4 to 6 of DA Form 2 –                               Yes
 Building work details have been completed and attached to this development application                                  Not applicable
 Supporting information addressing any applicable assessment benchmarks is with
 development application
 Note: This is a mandatory requirement and includes any relevant templates under question 23, a planning report          Yes
 and any technical reports required by the relevant categorising instruments (e.g. local government planning
 schemes, State Planning Policy, State Development Assessment Provisions). For further information, see DA
 Forms Guide: Planning Report Template.
 Relevant plans of the development are attached to this development application
 Note: Relevant plans are required to be submitted for all aspects of this development application. For further          Yes
 information, see DA Forms Guide: Relevant plans.
 The portable long service leave levy for QLeave has been paid, or will be paid before a                                 Yes
 development permit is issued (see 21))                                                                                  Not applicable


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                                                                                                        DA Form 1 – Development Application details
                                                                                                                      Version 1.1— 22 JUNE 2018