IDAS Forms REC17/0013

                                                                        Department of Infrastructure. Local Government and Planning

Table J

Lot on plan description for strategic port land                            Port authority for the lot

                                                                   .
Table K

Name of local government for the tidal area (if applicable)                Port authority for the tidal area (if applicable)




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

D      No    ~      Yes-ensure     the type. location and dimension of each easement is included in the plans submitted


9.      Does the proposal     include    new building   work or operational         work on the premises?     (Including any
        services)

B      No    D      Yes-ensure     the nature, location and dimension of proposed works are included in plans submitted


10.     Is the payment of a portable long service leave levy applicable               to this application?   (Refer to notes at the
        end of this form for more information.)

~      NCJ--9o to question 11           DYes

10a.    Has the portable    long service    leave levy been paid? (Refer to notes at the end of this form for more
        information.)

D No
D      Yes-complete  Table L and submit. with this application. the local governmenUprivate              certifier's copy of the
       accepted QLeave form

Table L

Amount paid                                                            Date paid          QLeave project number (6 digit number
                                                                       (dd/mm/yy)         starting with A, B. E. L, P or S)




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    Has the local government agreed to apply a superseded                planning     scheme to this application     under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

Q No
D      Yes-please   provide details below

Name of local government                           Date of written notice given          Reference number of written notice given
                                                   by local government                   by local government (if applicable)
                                                   (dd/mm/yy)




                                                                                                        IDAS form 1-Application details
                                                                                                         Version 4.3-5 December 2016