09/0134 - Operational Works - Prescribed Tidal Works - Transport Type 5 (Jetty) [As Published] · 142009.134

INTEGRATED PLANNING ACT 1997 Part A, Version 3.1, 3 March 2008

Attachments and supporting information (Comptete Table  ~ Use a separate row for each type of attachment or Infarmation, including information required under
this Parl) Please ensure all documentation submitted with this form, including other Parts of Form 1, or owner's consent, etc, are securely attached to this Part of the Form,

 

 

Description of attachment or information oe "
Table! Title (if applicable) Method of delivery to
(69 Pan © of Fam J amor’ consent. evidnos ofes0u? | (e.g Generel Autry, Janes Steet Trae Repos) | __ Dale assessment manager
Owners comsent . 2.2.09] attache
' Part CP Forwus Presce Chea tiolal work o
Drawi N°P477~-O1 Sie Cayaou 30.1. u
Fats uty 59-62 Bouton Delexs 32.1. a
77-O8 Bote § 30 .1.0F a
Afcrval Nkote EGeoate u

 

 

 

 

 

 

 

Portable Long Service Leave (PLSL) levy (Appticabye for certain building and construction work valued over $80.000 only}

10. The Portable Long Service Leave Levy (PLSL) is not applicable to this application if any of the following apply: ( ~ ‘box applicable)
(1 the application seeks a preliminary approval only;
4 the application is not for building and construction work under the Building and Construction Industry (Portable Long Service Leave)
Act 1991, section 3AA (e.g. the application is only for a change of use, or for the following types of work carried out solely for farming purposes:

land clearing, site preparation, earthworks, fences, fodder harvesting, clearing of encroaching vegetation, clearing of regrowth, thinning vegetation or
controlling weeds or pests);

all costs, that relate to the work both directly and indirectly, are less than $80,000, inclusive of GST; or @

LU the work is being carried out under an owner-builder permit issued under the Queensland Building Services Authonty Act 1991 -
Complete and submit a QLeeve Notification end Payment Farm (no payment required if owner-builder permit number stated) The receipied form must be sighted by the
assessment manager before 2 development permit can be given.

11. Is payment of a PLSL levy applicable to this application? (Refer to Q10 and the Advice below for more information)
xX No - End of Part A (J Yes - Answer Q12 below

42. Has the PLSL levy been paid?

O No - (NOTE: An application can be lodged prior to payment of the applicable PLSL levy. However, the levy must be paid and the receipted form sighted by the
Assessment Manager before a development permit may be given for this application. To pay the levy you will need to complete and submit a Notification
and Payment Form to QLeave.)

oO Yes - Compiate Table L. and submit. with the application. the “yellow* (Local Government's (Council) / Private Centifier’s) copy of the receipted QLeave Form.

QLeave Project Number
(6 digits, starting with A, B, E, L or P)

 

Table L Amount paid Date paid

 

 

 

 

 

 

 

 

OFFICE USE ONLY (For use by the Assessment Manager / Private Centifier) (Optional)

. Receivi Reference
Fee(8)| 2.4 Date received t[~-| eX Officer's name ? J Sree —. numbers Cj / (3 OF @
NOTIFICATION OF ENGAGEMENT OF PRIVATE CERTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

To: Council. | have been engaged as the private certifier for the building work referred to in this application.

 

 

Date of engagement Name BSA Certification license number Building classification’s

 

 

 

 

 

QLEAVE NOTIFICATION AND PAYMENT (for completion by assessment manager or private certifier if applicable)

. Date receipted form
~— paid Date paid sighted by Name of officer who sighted the form
assessment manager

 

Description of the work QLeave Project Number

 

 

 

 

 

 

 

 

 

Privacy Statement

The information collected on Form 1 will be used by the Department of infrastructure and Planning (DIP) in accordance with the processing and assessment of your Application.
Your personal details will not be disclosed for a purpose outside of the IDAS process, except where required by legislation (including the Freedom of information Act 1992) or
as required by Parliament. This information may be stored in a DIP database. The information collected will be retained as required by the Public Records Act 2002.

 

 

 

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