DA Form 1

     Listed on the Environmental Management Register (EMR) under the Environmental Protection Act 1994
 EMR site identification:
     Listed on the Contaminated Land Register (CLR) under the Environmental Protection Act 1994
 CLR site identification:


 5) Are there any existing easements over the premises?
 Note: Easement uses vary throughout Queensland and are to be identified correctly and accurately. For further information on easements and
 how they may affect the proposed development, see DA Forms Guide.
 [Z Yes - All easement locations, types and dimensions are included in plans submitted with this development
         application
    No


PART 3 - DEVELOPMENT DETAILS

Section 1 - Aspects of development
 6.1) Provide details about the first development aspect
 a) What is the type of development? (tick only one box)
 0 Material change of use             0 Reconfiguring a lot                0.Operational work                    STeuilding work

 b) What is the approval type? (tick only one box)
 A Development permit                 0 Preliminary approval                   Preliminary approval that includes a variation approval
 c) What is the level of assessment?
 0 Code assessment                    0 Impact assessment (requires public notification)
 d) Provide a brief description Of the proposal (e.g. 6 unit apartment building defined as muitl-unlt dwelling, reconfiguration of 1 lot into 3
    lots):


 e) Relevant plans
 Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms guide:
       Relevant plans.
 0 Relevant plans of the proposed development are attached to the development application
 6.2) Provide details about the second development aspect
 a) What is the type of development? (tick only one box)
     Material change of use               Reconfiguring a lot              0 Operational work                        Building work
 b) What is the approval type? (tick only one box)
 0 Development permit                 0 Preliminary approval                    Preliminary approval that includes a variation approval
 c) What is the level of assessment?
 0 Code assessment                    0 Impact assessment (requires public notification)
 d) Provide a brief description of the proposal (e.g. 6 unit apartment building defined as multi-unit dwelling, reconfiguration of 1 lot into 3
 tots):


 e) Relevant plans
 Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms Guide:
       Relevant plans.
 S Relevant plans of the proposed development are attached to the development application

 6.3) Additional aspects of development
   Additional aspects of development are relevant to this development application and the details for these aspects
   that would be required under Part 3 Section 1 of this form have been attached to this development application
 H Not required



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