07/1452 - Preliminary building works assessable against planning scheme [As Published]

 

  
 
  
     

 

 

Part A, Version 2.4, 29 May 2006

 

 

.. Land owner's consent to the making of this application Pe

 

 

 

 

 

 

 

 

 

 

 

involve a prescribed State resource,
Section 3, 1{10){a}{it) of the TPA prescribes that an

 

without evidence of the resource entitlement.
Advice for completing Q21 & 22

Refer toschedule'10 of the Integrated Planning
Regulation’ '1998'that prescribes the. nature of evidence
required by the State.in ‘support of the lodging of this
development:application.

for completing 023

The information in'(i) - (v) is mandatory if evidence is .

required: under, 022 (ii) or (iit) above: ‘

The official: stamp of.the: Department of Natural
Resources, Mines and Water is mandatory where the
application invotves any water or riverine quarry °
material under. the Water Act 2000, :

Section 3. 215A) allows  the.resour
lime the

   

    

Assessment triggers

This checklist does got apply if the application requires
the completion of Parts A and B of the Form onty. It
must be completed for afl other applications,

: lo9 This: application i is accompanied by evidence: (tick aéplicabe box)

than involving

QO (i) of the allocation of, or entitlement to, the.resource ~ attach evidence'and go to Q23{vi)
C1 (ii). the chief executive of the department administering the. resource is satisfied. the

. development i is. consistent with: an allocation of, or entitlement to, the resource - go

to Q23
C1 (ili}.the chief executive:of the department administering: the resource is satisfied the

development application may proceed in: the absence of an: vallocation of, or

” entitlement'to, the resource - go t0 023

23. Evidence of the resource entillement:

(i) - Resource entitlement / authority details (vil) Official stamp of the department
a > — applicable). 2
(i) Name of SSescieoet _

 

 

iti) * Position of delegated ‘officer

   

iV}iSignaluré of delegated officer -

 

 

 

 

(v) ‘Date’

(vi) _ date of evidence a . ‘

24. Is the IDAS Assessment Checklist completed and attached to this application?

CO Yes

 

 

 

NO - the assessment manager may refuse to accept this application on the
grounds that the application has not been properly made

 

Plans / drawings / reports

An application should be accompanied by details to
support the proposal & enable the assessment
manager, referral agencies and any person viewing
the application during public scrutiny or public
notification to understand the scope of lhe proposal
and any potential impact.

 

25. Plans/drawings/reports accompanying this application:

 

Plan / Drawing / Report Number

 

 

 

 

 

 

 

 

 

 

PLEASE NOTE: The assessment manager may refuse to accept an application that, ai the time of lod
and any other relevant part of Forn1,

OFFICE USE ONLY (applicable to assessment manager's)

igement, fails to provide all applicable information required by Part A

 

 

 

DATE TRecennic asricen’s | ‘ BEFERENCE Tt [ 1
[F FEE (S) bbe | _RECEIVED _ | 23h lo7 | NAMEIS LS Getto | wumsenss | CTLupsz |
Notification of Engagement of Private Certifier (Optional format) Y
To. Council, | have been engaged as the private certifier for the building work referred to in this application.

 

Dale ofengagement: / { Accreditation Number: __. __._ __, Name:

 

 

Signature: