07/1842 - MCU - Detached House [As Published] · 132007.1842

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INTEGRATED PLANNING ACT 1997 Part A, Version 2.4, 29 May 2006
Land owner's consent (if applicable) 20. Land owner's consent to the making of this application:
Section 3.2.1(3) of the IPA prescribes that an 7
application must contain, or be supported by, the Name Signature Date

 

written consent of the land owners, if the application

involves:

(i) amaterial change of use;

(i) reconfiguration of alot,

{ii) work on land below high-water mark & nat within a
canal as defined under the Coastal Protection and
Management Act 1995;0°

(iv) work on rail corridor !and defined under the
Transport Infrastructure Act 1994.

Section 3.8.1(2)(a) of tha IPA provides that

landowner’s consent is not required for a mobile or

temporary ERA .

For more information refer to Guide 1.

lepedreante.. LF AA.
(sen)

 

 

 

 

 

 

 

 

Resource entitlement (if applicable) 21. Does this application involve a State resource prescribed under a regulation (other than involving
Saction 3.2.1(5) of the IPA requires evidence of quarry material on State coastal land under the Coastal Protection and Management Act 1995)?

resource entiterent be given for applications that

involve a prescribed State resource. [XINNO - go to 024 (YES - goto 022

Section 3.2. t(10)(a){ii) of the IPA prescribes that an . tye . .
application ativan oe to be aropety made 22. This application is accompanied by evidence: (tick applicable box)

without evidence of the resource entitlement, C1 (i) of the allocation of, or entitlement to, the resource — attach evidence and go to 023(vi)
Advice for completin: & 22 >

 

 

Refer to scheduta 10 of the /ntegrated Planning C (ii) the chief executive of the department administering the resource is satisfied the
Regulation 1998 that prescribes the nature of evidence i i: i i f, or entitl rce -
rotuired by the Slaten support ofthe lodging ofthis development is consistent with an allocation of, or entitlement to, the resource - go
development application. lo

CI (i) the chief executive of the department administering the resource is satisfied the

development application may proceed in the absence of an allocation of, or
entitlement to, the resource - go fo 23

Advice for completing Q23 23. Evidence of the resource entitlement:
The information in {i) - (v) is mandatory if evidence is

required under 022 (i) or (i) above, (i) Resource entitlement / authority details (vii) Official stamp of the department
The official stamp of the Department of Natural administering the resource (if
Resources, Mines and Water is mandatory where the _ applicable)

application involves any water of riverine quarry (ii) Name of delegated officer

material under the Water Act 2000.

Section 3.2.1(5A) allows the resource manager to limit

the time the evidence may be used. Q23 {vi) must be iil iti

completed the evidences tne tiie. (iii) Position of — officer

(iv) Signature of delegated officer

 

 

 

 

 

 

 

 

 

 

 

 

 

(vy) Date
(vi) pen date of evidence t —
Assessment triggers 24. Is the IDAS Assessment Checklist completed and attached to this application?
Decent oo ab olte Parmoake 2 YES (CI NO - the assessment manager may refuse to accept this application on the
must be completed for all other applications. grounds that the application has not been properly made
Plans / drawings / reports 25. Plans/drawings/reports accompanying this application:
An application should be accompanied dy detaits to . qi
support the proposal & enable the assessment Plan / Drawing / Report Number Title

 

  

manager, referral agencies and any person viewing
the application during public scrutiny or public

notification to understand the scope ofthe proposal J Pomme pr represen cescncccccccccecseseccc css
and any potential impact.

 

 

 

 

 

PLEASE NOTE: The assessment manager may refuse to accept an application that, at the time of lodgement, fails to provide all applicable information required by Part A
and any other relevant part of Form 1.

 

 

 

OFFICE USE ONLY (epplicable to assessment manager's) a
DATE RECEIVING OFFICER'S , REFERENCE
Free) «=p SO | RECENED l (a TED, NAMEIS fs Aree a4 | RUBBERS lo hh Syr|

Notification of Engagement of Private Certifier (Optional forma,

 

To Council, | have been engaged as the private certifier for the building work referred to in this application.

 

 

Date ofengagement| / / Accreditation Number. __ Name:. Signature: