00157AD5.001

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                     INTEGRATED PLANNING ACT 1997                                                                           IDAS Assessment Checklist, Version 19.0, 2 March 2007
                     Contaminated land                         17.  The application involves: (tick the applicable box/es)                                 ,
                     Applications involving material change of use       H          H    H                i                         i        L
                     and! or reconfiguring alot may tigger this     Di      recontiguring alot for which all of part of the premises are
                    referral,                                                 {a}  premises mentioned in the IPA, schedule 8, part 1, table 2 -                            .
                     For more information refer to Guide 5.                      « item 5, including the exemption otherwise provided for by paragraph (d):
               ,     Unless you answered "none of the above" to                  + item 6, including the exemption otherwise provided for by paragraph (¢); or
                     Q17, the application requires assessment by the             + item 7, including the exemption otherwise provided for a mining activity or petroleum
                     Environmental Protection Agency (EPA). tf an                     tivity:
                     agency other than EPA is the assessment                       ac ivity; OF
                     manager for the application, EPA willbea                 (b)  in an area for which an area management advice has been given for unexploded
                     concurrence agency far the application in                     ordnance - complete Part N of Form 4
                     relation to this matter.                            os           :
                                                                    (_] (ii) a material change of use -                                   :
                                                                              {a)  made assessable under the IPA, schedule 8, part 1, table 2, items 5 to 7; or
                                                                              (b)  assessable against the planning scheme and if all or part of the premises is in an area
                                                                               _   for which an area management advice has been given for unexploded ordnance -
                                                                                   complate Part N of Form 1
                                                                    t., none of the above
                     Electricity infrastructure                18.  The application involves: (tick the applicable box/es)
                     ro       oman refer to schedule 2of the IP     L] (i)    reconfiguring a lot where any part of the lot is -
                    Unless you answered “none of the above" to                  subject to an easement in favour of a distribution entity or transmission entity under the
                     Q18, the application triggers refersal to the              Electricity Act 1994 and the easement is for a transmission grid or supply network under
                     agency to which the easement is granted in                 that Act; or
                    favour of as advice agency.                               * situated within 100m of a substation site;                                                   ©
                                                                    (1 (ii)   a material change of use, assessable against a planning scheme and not associated
                                                                              with reconfiguring a lot if -
                                                                              « any part of the premises is subject to an easement in favour of a distribution entity or
                                                                                transmission entity under the Efectricity Act 1994 and the easement is for a transmission       .
                                                                                grid or supply network under that Act; and                                                .
                                                                              « any structure or work that is the natural and ordinary consequence of the use is, or will be,
                                                                                located wholly or partly in the easement;
                                                                    C1 (iii)  a material change of use, assessable against a planning scheme and not associated
                                                                              with reconfiguring a lot if any part of the premises is situated within 100m of a substation
                                                                              site;
                                                                    L] (iv)   operational work that is filling or excavation assessable against the planning scheme,
                                                                              not associated with reconfiguring a lot, if -
                                                                              + any part of the premises is subject to an easement in favour of a distribution entity or
                               :          ‘                                     transmission entity Under the Electricity Act 1994 and the work is iocated wholly or partly in
                                                                                the easement;
                                                                     d        e the work is focated wholly or partly within 10m of a substation site;
                                                                         {v)_ none of the above.
                     Land designated for community             19.  Does the application involve development assessable against the planning scheme and on land
                     infrastructure                                 designated for community infrastructure?                                                                   ©
                     Applications involving development on land      Ar                        :             H             Saye ay
                     designated for community infrastructure may    (i)  intended to be supplied by a public sector entity; and
                     trigger this referral,                         (ii) on land not owned by or on behalf ofthe State; and                                .
                     For more information refer to schedule 2 of the ie
                     IP Reautation.                                 (iii) other than development —                                                     a
                     If you answered "YES" to Q19, the application      {a)   for the designated purpose; or
                     requires assessment by the chief executive of                ‘                                  i
                     the degartment administering the Act authorising    (b}  carried out by, or on behalf of, the designator.
                     the development for the designated purpose.         NO
                     If an agency other than the designator is the
                     assessmeni manager for the application, the    O YES                       .
                     designating agency will be a concurrence
.                    agency for the application in relation to this
                    matier.                                                                                                                     .

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