07/0466 - Modification to Alternative Siting Provisions [As Published] · 132007.466

INTEGRATED PLANNING ACT 1997

 

 

Part A, Version 2.4, 29 May 2006
Land owner’s consent (ff applicable) 20. Land owner's consent to the making of this application:
Section 3.2.1(3) of the IPA prasoribes that an Name Signature Date

application must contain, or be supported by, the

writien consent of the tand owner's, if the application

involves:

() amaterid change of use;

(reconfiguration of a fot,

{iif) work on land below high-water mark & not within a
canal as defined under the Coastal Protection and
Management Act 1995,0°

{Iv} work on sail corridor tand defined under the
Transport Infrastructure Act 1994.

Section 3.8.1(2)(a) of the IPA provides that

landowner’s consent is not required for a mobile or

temporary ERA .

For more information refer to Guide 1

 

0 Base Newle

 

 

 

 

 

 

 

 

 

Resource entitlement (if applicable) - 21.

Section 3.2.1(5) of the IPA requires evidence of
resource entiflement be given for applications that
involve a prescribed State resource.

Section 3.2.1(10}{a)(ii) of the IPA prescribes that an

application cannot be taken to be property made 22.

without evidence of the resource entitlement.

&
Refer to schedule 10 of the Infagrated Planning -
Regulation 1998 that prescribes the nature of evidence
required by the State in support of the lodging of this

Advice for completing Q23 23.

The information in {i} - {v) is mandatory if evidence is
required under Q22 (il) or (iii) above.

The official stamp of the Department of Natural
Resources, Mines and Water is mandatory where the
application involves any water or riverine quarry
material under the Water Act 2000.

‘Section 3.2.1(5A) allows the resource manager to limit
the time the evidence may be used. Q23 (vi) must be
completed if the evidence is time limited,

Assessment triggers 24.

This checklist does not apply if the application requires
the completion of Parts A and B of the Form onty. tt
must be completed for all other applications.

Does this application involve a State resource prescribed under a regulation (other than involving
quarry material on State coastal land under the Coastal Protection and Management Act 1995)?
- goto Q24 (I YES - goto 922
This application is accompanied by evidence: (tick applicable box)
(i) ofthe allocation of, or entitlement to, the resource — sttach evidence and go to Q23(v)
Ci (il) the chief executive of the department administering the resource is satisfied the

development is consistent with an allocation of, or entitlement to, the resource - go
to. Q23

O (iii) the chief executive of the department administering the resource is satisfied the
development application may proceed in the absence of an allocation of, or

entitlement to, the resource - goto 023

 

Evidence of the resource entitlement

(i) Resource entitlement / authority details (vii) Official stamp of the department
administering the resource (if
epplicable)

(ii) Name of — officer

(iii) Position of “ae officer

(iv) Signature of delegated officer

 

 

 

 

 

(v)_ Date

(vi) rm date of evidence fee

Is the IDAS Assessment Checklist completed and attactied to this application?

(Yes [INO - the assessment manager may refuse to accept this application on the
grounds that the application has not been properly made

 

 

 

 

 

Plans / drawings / reports 25.

‘An application should ba accompanied by details to
‘support the proposal & enable the assessment
manager, referral agencies and any person viewing
the application during public scrutiny or public
notification to understand the scope of the proposal
and any potential impact.

 

Plans/drawings/reports accompanying this application:
Plan / Drawing / Report Number Title Date

 

 

 

 

 

 

 

 

 

 

 

 

 

PLEASE NOTE: The assessment manager may refuse to accept an application that, at the time of ladgement, fails to provide all applicable information required by Part A
and any other relevant part of Form 1.

OFFICE USE ONLY (applicable to assessment manager's)

 

 

 

 

FEE (5) DATE RECEIVING OFFICER'S | REFERENCE |
RECEIVED NAMES : NUMBERS
Notification of Engagement of Private Certifier (Optional formal)
To. Council. | have been engaged as the private certifier for the building work referred to in this application.

| Date of engagement: / 1 Accreditation Number. __ Name: Signature: