Development Application part 1 of 2 Application Forms OPW13/0004

        ODD
     Table I      Lot on plan description for strategic port land                   Port authority for the lot



’*
     Table J     Name of local government for the tidal area (if applicable)        Port authority for the tidal area (if applicable)




      11. Are there any existing easements on the
                                                     premises? (e.g.for vehicular access, electricity, overland flow,water, etc.)
~
      oNo D Yes-ensure the type, location and dimension of each                   easement is included in the plans submitted




      12. Does the proposal include new    building work or operational work on the premises? (including any services)

      o No       D Yes-ensure the nature, location and dimension of proposed works             are included in   plans submitted


     13. Is the payment of a portable long service leave levy applicable to this
                                                                                      application? (refer to notes at the end of this
     form for more informaton)


     d     No-go to question 15          DYes

     14. Has the portable long service leave levy been paid? (refer to notes at the end of this form for more
                                                                                                                   information)

     D     No


     D Yes-complete table K and submit with this application the yellow local government/private certifier’s copy of the
           receipted QLeave form


     Table K     Amount paid                   Date paid              QLeave Project Number (6digit number starting with A, B,
                                                                      E, Lor P)




     15. Has the local government agreed to apply a superseded planning scheme to this
                                                                                                  application under section 96 of
t(   the Sustainable PlanningAct 2009?


     r:(   No


     o Yes-please provide details below

     Name of local government                          Date of written notice given     Reference number of written notice given
                                                       by local government              by local government (ifapplicable)




                 5                                                                            Application details-IDAS form :l
                                                                                                Version J.O 18December 2009