Development Applicaton for permit to damage vegetation - OPW13/0167

           12. Is the payment of a
                                   portable l ng service       eave levy applicable to this
           of this form for more
                ’"               information,)                            fj&       ,~,
                                                                                                       application? (Refer to notes at the end
                                                                                              ,pi.:                     "
                                                                                                                                               .




           rgj No-go to question 14           DYes
          ""13. Has the portable long service leave
                                                        levy been paid? (Refer to notes at the
           information.)                                                                   ".
                                                                                                          endpf this form for more                      ~.’t_           _. i;
                                                                                                                           "

                                                                                                                                                                        ’ik

           o    No

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

          Table N

         Amount paid             Date paid           QLeave project number
                                                                                    (6 digit number starting with A, 8, E, L or
                                 (dd/mm/yy)                                                                                                P)




         14. Has the local
                           gov rnment agre c:iiO apply a
         96 of the Sustainable
                               Planning Act 2009?
                                                         superseded
                                                            ,’l                 ’
                                                                                    plannin"g_Schem~ to this application under section                                  _




                                                                                                  "":")                .




                                                                                                                                    .4     \                      ",’
         o     No


         o Yes-please provide details below

     Name of local government
                                                          Date of written notice
                                                                                          given    Reference number of written notice
                                                          by local government                                                                       given
                                                                                                   by local government (if applicable)
                                                          (dd/mm/yy)



     ’15~List b low all of th"’e forms
    ’"                                    and    suppo"’rting Information   that’llaccompany this appl~ation (Include all IDAS
         forms\ .~h~C~lists, mand tor’Y"supportil)g information etc. that will be         submitted as part of this
     qyestici"n does not applY7for                                                                                    application. Note: this
                                     application~m~de online usi~~ Smart eDe..)
                                                                                                                               ""

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




    16. Applicant’s declaration         ’
                                                                                      ’;!"
                                                                                                                                ~t~:!’i’                 ,
                                                                                                                                                             /’




    o 8y making this application, I declare that all
                                                        information in this application is true
    provide false or misleading                                                                        and correct (Note:it is unlawful
                                  information.)                                                                                                    to




6
                                                                                                               IDAS form 1-Applcal on
                                                                                                                                      details
                                                                                                                 Version 2.017 December 2012