Development Application part 1 of 2 IDAS Forms

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           Q(No-go question       to                    14             0 Yes

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           o No
           o Yes-complete Table N and submit with this application the yellow local
                    receipted QLeave form                                                                                                                government/private certifier’s copy of the

         Table N

         Amount paId                            Date paid                           QLeave project number (6dIgit number
                                                                                                                                                            starting with A. B, E. L Or P)
                                               (dd/mmlyy)



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         o Yas-please provide details below

        Name of lOCal gove’rnment
                                                                                              Date of wrItten notice gIven                             Reference number of written notice gIven
                                                                                              by local government                                      by local government (Ifapplicable)
                                                                                              (ddfmmfyy)



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        Description of attachment or title of eHachrnent
                                                                                                     I                                                                  Method of lodgement to
                                            fQ~~                                  \         c,J      1.0                                                                assessment manager




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         By making this application. I declare that all information In this application Is true
                                                                                                and correct (Note:It Is unlawful to
     provIde fal3e or misleading Information.)




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                                                                                                                                                                                     IDAS form 1 Applicallon dGtails
                                                                                                                                                                                      Veusion2.0 17 Deceljlber 2012