0015E664.001

INTEGRATED PLANNING ACT 1997 __                           ft                     ;                  IDAS Assessment Checklist, Version 20,2Apil2007,
           Contaminated land     © 2  = 0-17. {The application involves: (tick the applicable box/es)                 tm
          - Applications involving material-change ofuse .- - ‘            ‘      .        ;     ,                  :        _                              .
          and/or reconfiguring lot may biggerthis «|    [*) (i) reconfiguring a lot for which all of part of the premises are
           -feferral,             ok                             (a) premises mentioned in the IPA, schedule 8, part 4, table 2 -.
           For more information refer'to Guides. * -           ___« item 5, including the exemption otherwise provided for by paragraph (4); 4
          _Unléss you.answered “none of the'dbove” to:   *.    |      item 6, including the exemption otherwise provided for by paragraph (e); or
           ‘Enviconmental Protection Ageney (EPA) fon          \   ‘  ten  4, including the exemption otherwise provided for a mining activity or petroleum
           Q17,-the:application requires assessment by the         “ej       i     H              j         i      i           ini     ivity
           agency other than EPA is the assessment                & activity; or
          manager for:the application, EPA will be a             {b)  sin an area for which an area management advice has been given for unexploded
          concurrence agency for the application in               / ordnance -- complete Part N of Form 1
           relation to this matter.      oe          :      .         vo          :       .                                                                       ‘
                      oo                   .            CJ (ii) a material change of use -                            .                                            ms
 :             Ost                        .      yo          -f  (a)  made assessable under the IPA; schedule 8, part 1, table 2, items 5 to 7; or
         ‘                                   -                  ‘(b)  assessable against the planning scheme and if all or part of the premises is in an area
                                                 |        ’           for which an area management advice has been given for unexploded ordnance -
          a                                      1                    complete Part N of Form 1
      ,            a.                     a      |      wii     none of the above _            a                                .                   .
.         -Electricity.infrastructure ~~         | 18. The application involves: (tick the applicable box/es)
       -.  For-more information refer to'schedule 2ofthe|P/ — [] (i) reconfiguring a fot where any part of the lot is —       .                       "
           Regulation.                    2S                           .                   .      :             gs    .           cat       .
           Untess'you answered “none of the'abovet to... |       e subject to an easement in favour of a distribution entity or transmission entity under the      :
   .       18, the-application tigers referraltothe |              Electricity Act 1994 and the easement is for a transmission grid or supply network under ©
          - agency to'which the easementis grantedin |            _ that Act; or                                                                           @
    ©;    Bvourof as advice agency.      ora                     e situated within 100m of a substation site;              .
                           te         cS 3 Ss           (.) (ii) a material change of use, assessable against a planning scheme and not associated
                           SY                           ,        with reconfiguring a lot if -
               co                     tore       |               * any part of the premises is subject to an easement in favour of a distribution entity or
          Pe                                 2               -     transmission entity under the Electricity Act 1994 and the easement is for a transmission
   -o               .                    ee      |:              - grid or supply network under that Act; and
            pe                                                   « any structure or work that is the natural and ordinary consequence of the use is, or willbe,”
             oo ta                             :                   located wholly or partly in the easement;                                    LL
 .        bf ets              .         ss]            [[) (il)  a material change of use, assessable against a planning scheme and not associated“
          tee                  Te     ee]                        with reconfiguring a lot if any part of the premises is situated within 100m of a substation, ..-”
           poe gs                  |     Oe 7           CJ (iv) operational work that is filling or excavation assessable against the planning scheme,      =
co         ve fee                     ae                ‘      * not associated with reconfiguring a lot, if -                                                       ;
          Se                          eS                         * any part of the premises is subject to an easement in favour of a distribution entity or
                             ee                                    transmission entity. under the Electricity Act 1994 and the work is located wholly or partly in
.                      a           ot           4                  the easement;                            .             ‘
                      fe                      _                  « the work is located wholly or partly within 10m of a substation site;                              .
                 eek: Soe                    od         Hw       none.ofthe above.                         ees             Ce                             {
          Land designated for community :      "" / 19. Does the application involve development assessable against the planning scheme and on land         ©
_..- +2 14 Infrastructure: .22     0. 4 *  4 <2]. - designated -for community infrastructure?:      .—-...~-———-          -                fe   ee ad /
  .      Applications involving development on land:     a                    “a               earsi       vy                                     0
          -designated for community infrastucture may’  (i) intended to be supplied by a public sector entity; and                          #3             A
          gWigger this teferral.: “earn Sette ge      ces). (ji) on land not owned by or on behalf of the State; and .                      wo     A in        “F
          {Rér,thore information ‘retertoschedule2 oftie:"| ay                       _                                                   |       ‘¢         AL .:
          ; IP Regulation: meant]                       (iii) other than development                                                     f.      Low           an
          “if you-answered “YES" to. Q19, the application: | . (a) _ for the designated purpose, or                                     |                 ae   ze
          ‘requirés assessment by the chilef.executive:of'. -        i          ;                                                     f              Ff   Oi
          ‘the   department administering the Achauthorsing | (b) carried out by, or on behalf of, the designator.                              ot oe                 |
          the development for the designated purpose, "| [Ano                                          :                        .    fF        moe   BOY            (
          Hf ani agency:other than‘the designators the              a                                                 oo,                        ,           a
           assessment manager forthe applicaton,the     Lives               :                                                                   soo4                 ‘
      ‘designating agency will be a concumence       _                        ,                                                  :                          g
          “agency for the application in telation'to this. |               oO
          myalier,;             ee               |                         oo   .               :          ,                      if                  ;

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