08/1491 - MCU - Detached House [As Published] · 132008.1491

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

‘Portable Long Service Leave {PLSL) levy (Applicable for certain buiding end 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: ( Tick box if applicable)
([] the 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),

CL all costs, that relate to the work both directly and indirectly, ara less than $80,000, inclusive of GST; or

L] the work is being carried out under an owner-builder permit issued under the Queens/and Building Services Authonty 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 pennit can be given.

11. Is payment of a PLSL levy applicable to this application? (Refer to Q10 and the Advice below for more information)?

No - End of Part A
(1 Yes - Answer Q12 below

 

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

 

Receiving officer's

. Ref
Fee (S)) (Z| Datoreceived 1.4) x oy name Py Xucee} numbers o8(17~a)

 

 

 

 

 

 

 

 

 

 

"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 Sf marth ‘1 ee te
engagement Name BSA Certification number Building classification/s

 

 

 

 

 

 

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

 

 

 

Date receipted
Description of the work QLeave Project Number | Amount paid ($)] Date paid fom ghee Name of offer who sighted the
O manager
1

 

 

 

 

 

 

 

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 willl be retained as required by the Public Records Act 2002.

 

Advice for completing Part A

General advice
e Part A of IDAS Development Application Form 1 must be completed and accompany all development applications. The applicant is responsible

for answering all questions fully and correctly, unless following a response there is a statement to go directly to another question. The

Assessment Manger may refuse to receive an application that is not properly made.
The IDAS Assessment Checklist must also be completed for all development applications, other than those requiring assessment against the

Building Act 1975 only, i.e. those applications requiring the completion of Parts A and B only.

Applicant details

. If the applicant is a company or organisation, a contact person must be nominated. The applicant's signature is not required to be provided
under the IPA.