DA Form 2

 9) Has the portable long service leave levy been paid?
     Yes – a copy of the receipted QLeave form is attached to this development application
     No – I, the applicant will provide evidence that the portable long service leave levy has been paid before the
     assessment manager decides the development application. I acknowledge that the assessment manager may
     give a development approval only if I provide evidence that the portable long service leave levy has been paid
     Not applicable (e.g. building and construction work is less than $150,000 excluding GST)
 Amount paid                        Date paid (dd/mm/yy)                QLeave levy number (A, B or E)
 $


 10) Is this development application in response to a show cause notice or required as a result of an enforcement
 notice?
    Yes – show cause or enforcement notice is attached
    No


 11) Identify any of the following further legislative requirements that apply to any aspect of this development
 application
     The proposed development is on a place entered in the Queensland Heritage Register or in a local
     government’s Local Heritage Register. See the guidance provided at www.des.qld.gov.au about the
     requirements in relation to the development of a Queensland heritage place
 Name of the heritage place:                                        Place ID:


PART 4 – REFERRAL DETAILS

 12) Does this development application include any building work aspects that have any referral requirements?
     Yes – the Referral checklist for building work is attached to this development application
     No – proceed to Part 5


 13) Has any referral agency provided a referral response for this development application?
     Yes – referral response(s) received and listed below are attached to this development application
     No
 Referral requirement                                         Referral agency                       Date referral response



 Identify and describe any changes made to the proposed development application that was the subject of the
 referral response and this development application, or include details in a schedule to this development application
 (if applicable)




PART 5 – BUILDING WORK DETAILS

 14) Owner’s details
     Tick if the applicant is also the owner and proceed to 15). Otherwise, provide the following information.
 Name(s) (individual or company full name)        John Maxwell Johnson and Margaret Johnson
 Contact name (applicable for companies)
 Postal address (P.O. Box or street address)      C/- Project Urban, PO Box 6380
 Suburb                                           Maroochydore BC
 State                                            Qld

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                                                                                                  DA Form 2 – Building work details
                                                                                                    Version 1.2— 7 February 2020