08/2078 - MCU - Detached House [As Published] · 132008.2078

INTEGRATED PLANNING ACT 1997 Part A, Version 3.1, 3 March 2008

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Attachments and supporting information (Complete Table !- Use a separate row for each type of attachment or information, including information required under
this Parl) Please ensure all documentation submitted with this form, including other Parts of Form 1, or owner's consent, etc, are securely attached to this Part of the Form.

 

 

 

 

 

 

 

 

 

 

 

 

 

Table } Description of atiachment or information Title (it applicable Method of delivery to
(eg. Pad i fom ent consent reo oe (e.g. General Aunts Jones Son Traffic Report) Date assessment manager
5 SUPPORTING LETTER gba ta 4 Cock [tal PRA MAL e.
: PLAN OF PROPOSED DWELUNG Draniag Wo eaty-~ PRA a
SITE, SURVEY OF EXISTING PrtUinG “
ASIESS MENT CHELK LIST [DAS f
PORT A? D eof FORMAL IPAS “

: Portable Long Service Leave (PLSL) levy (Applicable for certain building and construction work valued over $80, 000 only)
10. The Portable Long Service Leave Levy (PLSL) is not applicable to this application if any of the following apply: (~ box if applicable)
O be application seeks a preliminary approval only;
the application is not for building and construction work under the Building and Construction Industry (Portable Long Service Leave)

Act 1991, section 3AA (e.g. the application is only for a change of use, or for the following types of work carried out solely for farming purposes:
land clearing, site preparation, earthworks, fences, fodder harvesting, clearing of encroaching vegetation, clearing of regrowth, thinning vegetation or

controlling weeds or pests);
(all costs, that relate to the work both directly and indirectly, are less than $80,000, inclusive of GST; or

LC the work is being carried out under an owner-builder permit issued under the Queensiand Building Services Authority Act 1991 -
Complete and submit a QLeave Notification and Payment Form (no payment required if owner-builder permit number stated), The receipted form must be sighted by the
assessment manager before a development permit can be given.

11. Is payment of a PLSL levy applicable to this application? (Refer to Q10 and the Advice below for more information)
MNo ~ End of Part A (71 Yes - Answer Q12 befow

12, Has the PLSL levy been paid?

Oo No - (NOTE: An application can he lodged prior to payment of the applicable PLSL levy. However, the levy must be paid and the receipted form sighted by the
Assessment Manager before a development permit may be given for this application. To pay the levy you will need to complete and submit a Notification
and Payment Form to QLeave.)

oO Yes — Complete Table L and submit, with the application, the “yellow” (Local Government's (Council) / Private Cerlifier's} copy of the receipted QLeave For.

’ QLeave Project Number
(6 digits, starting with A, B, E, L or P)

 

Table L _ * “Amount paid .. © Date paid

 

 

 

 

 

 

 

 

OFFICE USE ONLY (For use by the Assessment Manager / Private Certifier) {Optional}

 

Receiving Reference

Fee ($) G 85 Date received i? f« afog officer's name EsCoQeny kowria numbers o6| act S

 

 

 

 

 

 

 

 

 

NOTIFICATION OF ENGAGEMENT OF PRIVATE CERTIFIER

 

To: Council. | have been engaged as the private certifier for the building work referred to in this application.

 

 

 

 

Date of engagement : : 2 Name - . noe BSA Certification license number Building classification/s

 

 

 

 

 

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

 

5 ° ; Amountoaid | . Date receipied form . . a : m
Description of the work =: QLeave Project Number 8) p Date paid sighted by : Name of officer who sighted the form
. . : ‘ : assessment manager :

 

 

 

 

 

 

 

 

 

 

Privacy Statement

The information collected on Form 1 will be used by the Department of Infrastructure and Planning (DIP) in accordance with the processing and assessment of your Application.
Your personal details will not be disclosed for a purpose outside of the IDAS process, except where required by legislation (including the Freedom of Information Act 1992) or
as required by Parliament. This information may be stored in a DIP database. The information collected will be retained as required by the Public Records Act 2002.

 

 

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