02.3 - Da Form 2 - S63 · OPW18/0008

9) Has the portable long service leave levy been paid?
☒ Yes – the yellow local government/private certifier’s copy of the receipted QLeave form is attached to this
development application
☒ No – I, the applicant will provide evidence that the portable long service leave levy has been paid before the
assessment manager decides the development application. I acknowledge that the assessment manager may give a
development approval only if I provide evidence that the portable long service leave levy has been paid
☒ Not applicable
Amount paid                     Date paid (dd/mm/yy)                    QLeave levy number (A, B or E)
$


10) Is this development application in response to a show cause notice or required as a result of an enforcement
notice?
☒ Yes – show cause or enforcement notice is attached
X No

11) Identify any of the following further legislative requirements that apply to any aspect of this development application
         The proposed development is on a place entered in the Queensland heritage register or in a local
    ☒    government’s Local Heritage Register. See the guidance provided at www.ehp.qld.gov.au about the
         requirements in relation to the development of a Queensland heritage place
Name of the heritage place:                                         Place ID:


PART 4 – REFERRAL DETAILS
12) Does this development application include any building work aspects that have any referral requirements?
X Yes – the Referral checklist for building work is attached to this development application
☒ No – proceed to Part 5

13) Has any referral agency provided a referral response for this development application?
☒ Yes – referral response(s) received and listed below are attached to this development application
X No
Referral requirement                          Referral agency                            Date referral response



Identify and describe any changes made to the proposed development application that was the subject of the referral
response and the development application the subject of this form, or include details in a schedule to this development
application (if applicable)



PART 5 – BUILDING WORK DETAILS
14) Owner’s details
☒ Tick if the applicant is also the owner and proceed to 15). Otherwise, provide the following information.
Name(s) (individual or company full name)        Jennifer and Peter Magarry
Contact name (applicable for companies)
Postal address (P.O. Box or street address)      C/- P O Box 566
Suburb                                           NOOSAVILLE


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                                                                                      DA Form 2 – Development Application details
                                                                                                        Version 1.0—3 July 2017