DA Form 1 · OPW26/0085

  

Note: By not agreeing to accept an information request |, the applicant, acknowledge:
* _ that this development application will be assessed and decided based on the information provided when making this development
application and the assessment manager and any referral agencies relevant to the development application are not obligated under the DA
Rules to accept any additional information provided by the applicant for the development application unless agreed to by the relevant

parties

X(] | agree to receive an information request if determined necessary for this development application
(11 do not agree to accept an information request for this development application

 

« Part 3 under Chapter 1 of the DA Rules will still apply if the application is an application listed under section 11.3 of the DA Rules or
* Part 2under Chapter 2 of the DA Rules will still apply if the application is for state facilitated development

Further advice about information requests is contained in the DA Forms Guide.

PART 7 — FURTHER DETAILS

XL) No

(1 Yes — provide details below or include details in a schedule to this development application

 

List of approval/development
application references

Reference number

Date

Assessment
manager

 

(] Approval
(2) Development application

 

(J Approval
(J Development application

 

 

 

 

(J Yes — a copy of the receipted QLeave form is attached to this development application

(No -1, the applicant will provide evidence that the portable long service leave levy has been paid before the
assessment manager decides the development application. | acknowledge that the assessment manager may
give a development approval only if | provide evidence that the portable long service leave levy has been paid

XL 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)

 

$NIL

 

 

 

XC No

 

(2 Yes — show cause or enforcement notice is attached

 

 

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DA Form 1 — Development application details
Version 1.6— 2 August 2024