07/2173 - Operational Works - Prescribed Tidal Works Transport Type 5 - Pontoon [As Published] · 142007.2173

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INTEGRATED PLANNING ACT 1997

Part A, Version 2.4, 29 May 2006

 

Land owner’s consent (if applicable)
Section 3.2.1(3) of the IPA prescribes that an

 

 

20

, Land owner's consent to the making of this application:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

This checklist doas ot apply # the application requires
tha completion of Parts A and 8 of the Form only. It
must be completed for all other applications.

YES

application must contain, or be supported by, the Name Signature Date
written consent of the land owners, if the application ;
involves: (i)
(i) amatefatchangecfuse, fee eee eee ee eee eee ee ce eee eee nee eee eed
(fi) reconfiguration of a lot; -
{ti} work on land below high-water mark & not within a (ti)
canal as defined under the Coastal Protection and} | cee eed ccccececccc ccc ee eee eee eee eeee dees ee eeeee ed
Management Act 1995;0r an
{iv) work on rail corridor land defined under the (iii)
Transport infrastructure Act 19%, pce eee ec eee eee eeeeee---do--------eee ed
Section 3.8.1(2)(a) of the IPA provides that .
landowner's consent is not required for a mobile or (iv)
temporaryERA, eee enn nee e ee eee cee cee eee eee een ee denne eee nce cee ee eee dane eeee eee eed
For mora information refer to Guide 1. (vy)
Resource entitlement (applicable) 21. Does this application involve a State resource prescribed under a regulation (other than involving
Section 9.2.1(5) of the IPA requires evidence of quarry material on State coastal land under the Coastal Protection and Management Act 1995)?
resource entivemient ba given for applications that
involve a prescribed State resource. O NO - go to a24 x YES - go to Q22
Section 3.2.1(10}aYil) of the IPA prescribes that an + ee, + . . .
application eannot be taken to be properly made 22, This application is accompanied by evidence: (tick applicable box)
“tet ouence one ve entidement, (1 ofthe allocation of, or entitlement to, the resource - attach evidence and go to Q23(vi)
Rafer to schedule 10 of the Integrated Planning LD (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 -
racaled bythe Stata oupportof fe lodging of Tus development is consistent with an allocation of, or entitlement to, the resource ~ go
development application, - | ‘ vy . . a
e (iii) 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 to 023
Acti for complting 028 23. Evidence of the resource entitlement:
tt An (I) = (vi indatory I 7 A 5 . ar ‘
a cara evidence I (i) Resource entitlement / authority details (vii) Official stamp of the department
Tho official stamp of the Department of Natural SEE LETTER FROM EPA administering the resource (if
Resources, Mines and Water is mandatory where the 7 - applicable)
application involves any water or riverine quarry (ii) Name of delegated officer
aon 32.154) allows Po pn to init
1 time the evidence may be use: (vi) must iti ji
competed tthe evidence mo tinted (iii) Position of delegated ofticer
(iv) Signature of delegated officer
(v) Date
(vi) _ date of evidence eee
Assessment triggers 24. Is the IDAS Assessment Checklist completed and attached to this application?

LJ NO - the assessment manager may refuse to accept this application on the

grounds that the application has not been property made

 

Plans / drawings / reports

An application should be accompanied by datalls 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 af the proposal
and any potential impact,

 

25. Plans/drawings/reports accompanying this application:

 

 

 

 

Plan / Drawing / Report Number Title Date
(i) JSP-SJ-19290 iss 8 SITE PLAN 480)
Fi) USP-Syt9201 ss BE ELEVATION =—i(itstiséid*r: 29-8.07 |
Bee TSP -SW-O4S ESSE | Conceere pysiTY PILE | 20» F- |
Ww) 75P-SS- 00 Iss 4 Potten Cor, 2bok

 

 

 

 

 

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 (applicable to assessment manager's)

 

 

 

 

 

Date ofengagement / /

Accreditation Number:

___ Name:

Signature:

” DATE RECEIVING OFFICER'S REFERENCE
[ew 2075 | sectnen | (7ho for | Nee > Siac, | mummers [07/2473 |
thos trues . Notification of Engagement of Private Certifier (Opdonal tormal7, . Sones
To, Council. | have been engaged as the private certifier for the building work referred to in this application.