Application Form

 

CL Listed on the Environmental Management Register (EMR) under the Environmental Protection Act 1994
EMR site identification: |
LJ Listed on the Contaminated Land Register (CLR) under the Environmental Protection Act 1994
CLR site identification: |

 

 

 

 

5) Are there any existing easements over the premises?

Note: Easement uses vary throughout Queensland and are to be identified correctly and accurately. For further information on easements and
how they may affect the proposed development, see DA Forms Guide.

L] Yes - All easement locations, types and dimensions are included in plans submitted with this development

 

application

[IX] No

 

 

 

PART 3 —- DEVELOPMENT DETAILS

Section 1 — Aspects of development
6.1) Provide details about the first development aspect

 

a) What is the type of development? (tick only one box)

 

LC Material change of use L Reconfiguring a lot x Operational work C1 Building work
b) What is the approval type? (tick only one box)
[] Development permit LJ Preliminary approval LJ Preliminary approval that includes

a variation approval

 

c) What is the level of assessment?
[Kl Code assessment CJ Impact assessment (requires public notification)

d) Provide a brief description of the proposal (e.g. 6 unit apartment building defined as multi-unit dwelling, reconfiguration of 1 lot into 3
lots):

Development permit Ae qporntonck world (fa : ;
a i NMS cap'ng, Stora vuter, Qccest As wey
+ (oad 6M AG d

e) Relevant plans

Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms quide:
Relevant plans.

{4 Relevant plans of the proposed development are attached to the development application
6.2) Provide details about the second development aspect
a) What is the type of development? (tick only one box)

 

 

 

 

CL Material change of use LC Reconfiguring a lot CJ Operational work (1 Building work

b) What is the approval type? (tick only one box)

C1 Development permit LJ Preliminary approval (] Preliminary approval that includes a variation
approval

 

c) What is the level of assessment?
LJ Code assessment CJ Impact assessment (requires public notification)

 

d) Provide a brief description of the proposal (e.g. 6 unit apartment building defined as multi-unit dwelling, reconfiguration of 1 lot into 3
lots):

e) Relevant plans

Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms Guide:
Relevant plans.

CL Relevant plans of the proposed development are attached to the development application

 

 

 

Page 3
DA Form 1 — Development Application details
Version 1.1— 22 JUNE 2018