Ida form 122052017 · OPW17/0180

 

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 Has the local government agreed to apply a superseded planning scheme to this application under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