DA Form 1

 7)     Does the proposed development application involve any of the following?
 Material change of use                      ☒      Yes – complete division 1 if assessable against a local planning instrument
 Reconfiguring a lot                         ☐      Yes – complete division 2
 Operational work                            ☐      Yes – complete division 3
 Building work                               ☐      Yes – complete DA Form 2 – Building work details

Division 1 – Material change of use
Note: This division is only required to be completed if any part of the development application involves a material change of use assessable against a
      local planning instrument.
 8.1) Describe the proposed material change of use
 Provide a general description              Provide the planning scheme definition (include               Number of dwelling           Gross floor
 of the proposed use                        each definition in a new row)                                 units (if applicable)        area (m²)
                                                                                                                                       (if applicable)

 Dwelling House                             Dwelling House                                                1




 8.2) Does the proposed use involve the use of existing buildings on the premises?
  ☐     Yes
  ☒     No

Division 2 – Reconfiguring a lot
Note: This division is only required to be completed if any part of the development application involves reconfiguring a lot.
 9.1) What is the total number of existing lots making up the premises?


 9.2) What is the nature of the lot reconfiguration? (tick all applicable boxes)
  ☐     Subdivision (complete 10)                                           ☐      Dividing land into parts by agreement (complete 11)
  ☐     Boundary realignment (complete 12)                                  ☐      Creating or changing an easement giving access to a
                                                                                   lot from a construction road (complete 13)

 10) Subdivision
 10.1) For this development, how many lots are being created and what is the intended use of those lots:
 Intended use of lots created                Residential            Commercial             Industrial             Other, please specify:


 Number of lots created
 10.2) Will the subdivision be staged?
  ☐     Yes
  ☐     No
 How many stages will the works include?
 What stage(s) will this development application
 apply to?




                                                                                                                                                 Page 4
                                                                                                              DA Form 1 - Development application details
                                                                                                                        Version 1.3 - 28 September 2020