Development Application part 1 of 1 Covering Letter, Owners Consent , IDAS Forms 1 & 5 - MCU13/0081

12. 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 information.)


[K] No-go to question 14              DYes

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

o       No


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

Table N

Amount paid             Date paid           QLeave project number (6 digit number starting with A, B, E, L or P)

                        (dd/mm/yy)




14. Has the local government agreed to apply a superseded planning scheme to this application under section
96 of the Sustainable Planning Act 2009?


IKI     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 (if applicable)
                                                  (dd/mm/yy)




    15. List below all of the forms and supporting information that accompany this application (Include alllDAS
forms, checklists, mandatory supporting information etc. that will be submitted as part of this application. Note: this
question does not apply for applications made online using Smart eDA.)


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


IDAS Form 5                                                                                   Mail

Architectural Proposal Plans prepared by Hayes Anderson Lynch Architects                      Mail


Applicant Town Planning Report                                                                Mail




16. Applicant’s declaration


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




6                                                                                                    IDAS farm 1-Applicafian details
                                                                                                      Version 2.0 17 December 2012