DA Form 1 0185_001-1

 

(2 Listed on the Environmental Management Register (EMR) under the Environmental Protection Act 1994

EMR site identification:

CD Listed on the Contaminated Land Register (CLR) under the Environmental Protection Act 1994
CLR site identification: |

 

 

 

 

 

») Are there any existing easements over the oremises?

  
 

ane MOLE resn ht ei eis fem om ener ed correctly and accurately, Por further information on easements anc

      

f (ine proposed deveionmen), see

C1 Yes ~ All easement locations, types and d
application

C1 No

PART 3 —- DEVELOPMENT DETAILS

Forms G

imensions are included in plans submitted with this development

 

 

 

Section 1 — Aspects of development
6.1) Provide details about the first development aspect

  
   

 
  
   

  
  

 

a) What is the type of development? (tick only one box)

CO Material change of use 1 Reconfiguring a lot [ Geealional work C1 Building work
b) What Is the approval type? (tick only one box)

CL] Development permit (1 Preliminary approval (1 Preliminary approval that includes

a variation approval

 

c) What is the level of assessment?
(J Code assessment LJ Impact assessment (requires public notification)
d) Provide a brief description of the proposal (e.g. 6 unit apartment building defined as multi-unit dwelling, reconfiguration of 1 fot into 3

ris: PRIVEWAM §=CEOSSOVERS % STORK NII LATEK D/ECHPE
Crn€cr7eN

e) Relevant plans
Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms guide:

 

 

wy Relevant plans of the proposed development are attached to the development application

6.2) Provid ails about the second development aspect

   

a) What is the type of development? (tick only one box)

 

( Material change of use CO Reconfiguring a lot (J Operational work (1 Building work

b) What is the approval type? (tick only one box)

1 Development permit (1 Preliminary approval (1 Preliminary approval that includes a variation
approval

 

c) What is the level of assessment?
(1 Code assessment U1 Impact assessment (requires public notification)

d) Provide a brief description of the proposal (e.g. 6 unit apartment building defined as multi-unit dwelling, reconfiguration of 1 lot into 3
lots):

 

e) Relevant plans
Note: Relevant plans are required to be submitted for all aspects of this development application. Fer further information, see DA Forms Guide:
Relevant plans.

LC Retevant plans of the proposed development are attached to the development application

 

 

 

Page 3
DA Form 1 — Development Application details
Version 1.1— 22 JUNE 2018

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