Development Application part 1 of 2 - Covering Letter IDAS Forms 1 and 6 4 Stevens St Sunrise Beach · OPW10/2029

Privacy-the information collected in this form 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 Right to lnformationAct zoog) or as required
by Parliament. This information may be stored in a departmental database. The information collected will be retained as
required bythepPtr                   ooz.



OFFICE USE ON LY
 Date received                                           Reference numbers                aP^^ol ^zq
NOTIFICATION     F EN GAG            1' PRI1RME-CEWTIFIER
 To                                       Council. I have been engaged as the private certifier for the building work referred
                                          to in this application


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




QLEAVE NOTIFICATION AND PAYMENT (for completion by assessment manager or private certifier if applicable)
                                                                             Date receipted
                          QLeave Project    Amount paid                      form sighted by Name of officer who
Description of the work                                        Date paid
                          Number             ($)                             assessment           sighted the form
                                                                             manager




 The Srlstainable Planning Act 200g(SPA) is administered by the Department of Infrastructure and Planning. This form and
 all other required application materials should be sent to your assessment manager and any referral agencies.


                                                                                                           -/DAS form i
                                                                                           Version 1.0 18 December 2009