MCU11/0080 Development Application part 1 of 2 Application forms 14 Stevens St SUNSHINE BEACH

0 00                                                                                                                           qm
                                                                                                                               12 Does the proposal Include new building work or operational work on the premises? (including any
                                                                                                                                  services)

q No
                                                                                                                               L NO [-'Yes - ensure the nahue ocauon and dimensions of proposed works are induded in plans submitted

® Yes - complete either table D, table E or table F as applicable
                                                                                                                               13. Is the payment of a portable long service leave levy applicable to this application? (refer to the notes at the
                                                                                                                                  end of this form for more information)
Table D (note: do not complete this table If lodging the application on-line using Smart eDA)
                                                                                                                               q No - Go to question 15                   ® Yea

Name of owner/s of the land                                                                                                    111. Has the portable long service Nave levy been paid? (refer to notes at the end of this form for more
                                                                                                                               information)
I/We. the above-mentioned owner/s of the land, consent to the making of this application.

                                                                                                                               ® No
Signature of owners of the Ian
                                                                                                                                             complete table K and submit with this application the yellow local government/ private certifiers copy of
                                                                                                                               q Yes -
Date                                                                                                                                         the receipted QLeave Form


Table E                                                                                                                        15. Has the local government agreed to apply a superseded planning scheme to this application under
                                                                                                                                   section 96 of the Sustainable Planning Act 2009?

Name of owner/s of the land         S Knox & D Tonuff
                                                                                                                               ® No
 ® The owners written consent is attached or will be provided separately to the assessment manager
                                                                                                                               q    Yes - provide details below

Table F
                                                                                                                               16. List below all of the forms and supporting information that accompany this application (include all IDAS
                                                                                                                               forms, checklists, mandatory supporting information etc. that will be submitted as part of this application. Note: this
Name of owner/s of the land                                                                                                    question does not apply for applications made online using Smart eDA)

q By making this application, I, the applicant, declare that the owner has given written consent to the making of                                                                                                              Method of lodgement to
                                                                                                                                                            Description of attachment or title of attachment
  the application.                                                                                                                                                                                                              assessment manager

                                                                                                                                                IDAS Form 1 & 5, checklist and architectural plans etc (see attached)
9. Does the application Involve a state resource? (e.g. the application Involves stale land, or taking quarry
materials. Refer to the notes at the end of this form for more Information)


Z No                              q Yes - complete table G
                                                                                                                               ® By making this application, I declare that all Information in this application is true and correct (note: It is
                                                                                                                                   unlawful to provide false or misleading information).


q        adjacent to a water body, watercourse or aquifer (e.g creek, river, lake, canal) - complete table H
q        on strategic port land under the Transport Infrastructure Act 1994 - complete table I
q        in a tidal water area - complete table J

    Are there any existing easements on the promises? (e.g. for vehicular access, electricity, overland now,
    water, etc.)

    No    q Yes - ensure the type, location and dimension of each easement is included in the plans submitted




                                                                                            Appxicanon Details - /DAS form 1                                                                                              Apivrcation Der ails - IDAS form 1
                                                                                              Version 1.0 18 December 2009                                                                                                  Version 10 18 December 2009