OPW13/0072 Application for permit to damage vegetation 22 Noosa Parade Noosa Heads

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         12. Is the payment of a portable long service leave levy applicable to this application? (Refer to notes at the end
         of this form for more information.)


         csV No-go to question 14           DYes

         13. Has the portable long service leave levy been paid? (Referto notes at the end of this form for more
         information.)

         cs(   No


         o     Yes-complete Table N and submit with this application the yellow local governmenUprivate certifier’s copy of the
               receipted QLeave form

         Table N

         Amount paid            Date paid            QLeave project number (6digit number starting with A. B, E, L or P)

,J(v\-                          (dd/mm/yy)




         14. Has the local government agreed to apply a superseded planning scheme to this application under section
         96 of the Sustainable Planning Act 20091


         cst No
         o     Yes-please 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)
                                                           (dd/mm/yy)




          15. List below all of the forms and supporting information that accompany this application (Include all IDAS
         forms, checklists. mandatory supporting information etc. that will be submitted as part of this application. Note: this
         question does not apply for applications made online using Smart eDA.)


         Description of attachment or title of attachment                                           Method of lodgement to
                                                                                                    assessment manager




          16. Applicant’s declaration


         gBy making this application, I declare that all information in this application is true and correct (Note:it is unlawful to
         provide false or misleading information.)




         6                                                                                                IDAS form 1-Application details
                                                                                                           Version 2.017 December 2012