Ida form 122052017 · OPW17/0180

Page 2

 

Department of intrastructure, Local Government and Plenning

Email address (non-mandatory requirement) - (ed @pa-
@ F, kde.

Applicant's reference number (non-mandatory
requirement)

1. Whatis 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.
LJ Material change ofuse [_] Reconfiguring a lot Building work
b) What is the approval type? (Please only tick one box.) fo
al Preliminary approval ra Preliminary approval Development permit
under $241 of SPA under s241 and s242
of SPA

¢) 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.)

Ad a Seard Clrieway to Q Commer (ot,

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

 
 

 

It] Operational work

 

 

Impact assessment C] 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) Whatis the nature of development? (Please only tick one box.)
oO Material change of use oO Reconfiguring a lot CT Building work | Operational work

 

b) Whatis the approval type? (Please only tick one box.)

{_] Preliminary approval [] Preliminary approval = [—] Development
under $241 of SPA under 8247 and s242 permit
of SPA

ce) 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. )

ee

oO Impact assessment O Code assessment |

cd) What's the level of assessment?

Table C—Additional aspects of the application (|f there are additional aspects to the application please list in @
separate table cn an extra page and attach to this form.)

(L] Refer attached schedule [-] Not required

    
   

IDAS form 1—Agplication details
Version 4.2—6 December 2076

Page 3

 

Department of Infrastructure, Local Guvernment and Planning

2. Location of the premises (Complete Table D and/or Table E as applicable, Identify each lot in a separate row.)

Table D—Street address and |ot on plan for the premises or street address and lot on plan for the land adjoining or
adjacent to the premises (Note: this table is to be used for applications involving taking or interfering with water.)
(Attach a separate schedule if there is insufficient space in this table.)

[4 Street adaress and lot on plan (All lots must be listed.)

O Street address and lot on plan for the land adjoining or adjacent to the premises (Appropriate for
development in water but adjoining or adjacent to land, e.g. jetty, pontoon. All lots must be listed.)

      
  

   
   
 

 
 
  

Street address Lot on plan description | Local government area

(e.g. Logan, Cairns)

    

Street name and official suburh/
locality name

Plan type
and plan no.

 

| Planning scheme details (If the premises involves multiple zones, clearly identify the relevant zone/s for each lot in a
separate row in the below table, Non-mandatory)

Apolicable zone / precinct Applicable local plan / precinct

[@ | lle =l ———

Table E—Premises coordinates (Appropriate for development in remote areas, over part of a lot or in water not
adjoining or adjacent to land e.g. channel dredging in Moreton Bay.) (Attach a separate schedule if there Is Insufficient
space in this table.)

Coordinates Zone | Datum Local government

(Note: place each set of coordinates in a separate row) reference area (if applicable)
Northing Latitude

    

    
   

Applicable overlay/s

    

 

 

      

Easting Longitude

         

LC) apasa
C] weses
| other

3, Total area of land on which the development is proposed (indicate square metres)

a
4. Current use/s of the premises (e.c. vacant land, house, apartment building, cane farm etc.)

 

 

 

(DAS form 1—Application datails
Version 4.3—5 December 2018

Page 4

 

Department of Intrastructure, local Government and Planning

 

No [] Yes—provide details below

 

List of approval reference/s Date approved (dd/mmiyy) Date approval lapses (dd/mmiyy)

|
| 6. ls owner's consent required for this application? (Refer to notes at the end of this form for more information.)

No

 

oO Yes—compiete either Table F, Table G or Table H as applicable

Table F

Name of owner/s of the land

 

We, the above-mentioned owner/s of the land, consent to the making of this application.

 

Signature of owner/s of the land =|

Date

Table G
Name of owner/s of the land

 
 
   
 

| :
| oO The owner's written consent is attached or will be provided separately to the assessment manager.

Table H

 

Name of owner/s of the land

C1] py making this application, |, the applicant, declare that the owner has given written consent to the making of the application.

[7 Identify if any of the following apply to the premises (Tick applicable box/es.)

Adjacent to a water body, watercourse or aquifer (e.g. creek. river, lake, canal)—compiete Table |

 

 

~

On strategic port land under the Transport Infrastructure Act 1994—complete Table J

In a tidal water area—complete Tabie K

On Brisbane core port land under the Transport Infrastructure Act 1994 (No table requires completion.)

On airport land under the Airport Assets (Restructuring and Disposal) Act 2008 (no table requires completion)

OOOOOO

Listed on either the Contaminated Land Register (CLR) or the Environmental Management Register (EMR) under
the Environmental Protection Act 1994 (no table requires completion)

———————
Table |

Name of water body, watercourse or aquifer

IDAS farm t—Apniication details
Version 4.3-—5 Decambar 2016

Page 5

 

rrment of infrastructure, Local Government and

 

| Table J
——————

Lot on plan description for strategic port land Port authority for the lot |
“Table K

Name of local government for the tidal area (if applicable) Por authority for the tidal area (if applicable)

8. Are there any existing easements on the premises? (@.9. for vehicular access, electricity, overland flow,
waiter etc)
5 No O Yes—ensure the type, location and dimension of each easement is included in the plans submitted

3. Does the proposal include new building work or operational work on the premises? (including any
services)

No | Yes—ensure the nature, location and dimension of proposed works are included in plans submitted

10. Is the payment of a portable long service leave levy applicable to this application? (Refer to notes at the |

id of this farm for mare information.) Lie
y No—go to question 11 [] ‘Yes
10a. Has the portable long service leave levy been paid? (Refer to notes at the end of this form for more
information.) ;

[] No

| Yes—complete Table L and submit, with this application, the local government/private certifier's copy of the
accepted QOLeave form

 

   

Table L
Amount paid Date paid QLeave project number (6 digit number
(dd/mm/yy) starting with A, B, E, L, P or S)

=a

11. Has the local government agreed to apply a superseded planning scheme to this application under
| section 96 of the Sustainable Planning Act 2009?

      
 

[4 No
[-] Yes—piease provide details below

Name of local government | Date of written notice given | Reference number of written notice given

by local government by local government (if applicable)
(ddimmiyy)

a

 

IDAS form 1—Appiication details
Version 4.3—5 December 2016

Page 6

Description of attachment or title of attachment

 

Department of Intrastructure, Local Governmentand Flenning

12. List below all of the forms and supporting information that accompany this application (include all |DAS
forms, checklists, mandatory supporting information etc. that will be submitted as part of this application)

     
   

Method of lodgement to
| assessment manager

NVena vl

  

13. Applicant's declaration

=F making this application, | declare that all information in this application Is true and correct (Note: it is unlawful to

provide false or misleading information)

Notes for completing this form

Section 261 of the Sustainable Planning Act 2009 prescribes when en application is a properly-made application,
Note, the assessment manager has discretion to accept an application as properly made despite any non-
compliance with the requirement to provide mandatory supporting information under section 280(1)(c) of the
Sustainable Planning Act 2009

Applicant details

Where the applicant is not a natural person, ensure the applicant entity is a real legal entity.

Question 1

Schedule 3 of the Sustainable Planning Regulation 2009 identifies assessable development and the type of
assessment. Where schedule 3 identifies assessable development as “various aspects of development” the
applicant must identify each aspect of the development on Tables A. 8 and C respectively and as required,

Question 6

Section 263 of the Sustainable Planning Act 2009 sets out when the consent of the owner of the land is required for
an application. Section 260(1)(e) of the Sustainable Planning Act 2009 provides that if the owner's consent is
required under section 263, then an application must contain, or be accompanied by, the written consent of the
Owner, or include a declaration by the applicant that the owner has given written consent to the making of the
application, If a development application relates ta a state resource, the application is not required to be supported
by evidence of an allocation or entitlement to a state resource. However, where the state is the owner of the
subject lend, the written consent of the state, as landowner, may be required, Allocation or entitlement to the state
resource is a separate process and will need to be obtained before development commences.

Question 7

If the premises is listed on either the Contaminated Land Register (CLR) or the Environmental
Management Register (EMR) under the Environmental Protection Act 1994 It may be necessary to
seek compliance assessment. Schedule 15 of the Sustainable Planning Regulation 2009 identifies
where compliance assessment is required.

Question 10

°

The Building and Construction industry (Portable Long Service Leave) Act 1997 prescribes when the portable long
service leave levy is payable.

The portable long service leave levy amount and other orescribed percentages and rates for calculating the levy
are prescribed In the Building and Construction Industry (Portable Long Service Leave) Regulation 2013.

IDAS form 1—Application details
Version 4 3—5 December 2076

Page 7

Decertment of infrastructure, Local Government and Planning

Question 10a

* 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 1997 requires the levy to be paid before a development
permit is issued.

¢ Building and construction industry notification and payment forms can be completed on the QLeave website at
www.qleave.aid.gov.au. For further information contact QLeave on 1800 803 481.

Privacy—The information collected in this form will be used by the Department of Infrastructure, Local Government
and Planning (DILGP}, assessment manager, referral agency and/or building certifier in accordance with the
processing and assessment of your application. Your personal details should not be disclosed for 2 purpose autside of
the IDAS process or the provisions abaut public access to planning and development information in the Sustainable
Planning Act 2009, except where required by legislation (including the Right fo 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 Reference numbers

 

NOTIFICATION OF ENGAGEMENT OF A PRIVATE CERTIFIER
To |. Council, | have been engaged as the private certifier for the
building work referred to in this application
{ tGainivane: (aki
Date ofengagement | Name Building

classification/s
| |

|

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

 

BSA Certification license
number

 
  

 

  

 

 

 
   

Date receipted
form sighted by
assessment
manager

Name of officer
who sighted the
form

   

Description of the work QLeave project Amount paid
($)

ruber Date paid

    
   
    

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.

(DAS form 1—Application details
Version 4.3—5 December 2016