09/1270 - MCU - Detached House [As Published] · 132009.1270

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

Attachments and supporting information (Conjiere Tabu 1 -Use 4 separate iow fx vaca ape of aitechment or edomauon, neladeg stomatan chqused 3
under tis Part) Please ensure all documentation submitted with this form, incksding other Parts of Form 1, o owner's consent, ete. are securely attached to this Part of the Form. .

 

 

 

 

 

 

 

 

t . .
i Description of attachment or information Ti i. .
ho, . . itle if appiicabte) Method of defivery to
' ner ¢
feg. Pane oF om 4 onan worsen. omens of ee (e.g, General Aunoriy. james Suecttraltic Repary) Date assessment manager
1 Owner's Consent | “individual owner's consent" 8/9/09 !
2 Plans and elevations } “proposed new house” 8/9/09 I i

 

 

 

 

Portable Long Service Leave (PLSL) levy (Appicatte tx cena buliing and cestucton work walune over $80, 000 only!
10. The Portable Long Service Leave Levy (PLSL) is not applicable to this application if any of the following apply: ; i... s+

 

[| the application seeks a preliminary approval only:

[X} the application is not for building and construction work under the Building and Construction Industry (Portable Long Service
Leave) Act 1997, section 3AA (e.g. the application is only for a change of use, or for the following lypes of work carried out solely for
farming purposes: land clearing, site preparation, earthworks, fences, fodder harvesting, clearing of encroaching vegelation, clearing of
regrowth, thinning vegetation or controlling «eds or pests),

([) all costs, that relate to the work both directly and indirectly, are tess than $80,000, inclusive of GST: or La

 

i the work is being carried out under an owner-builder permit issue

feasats eh df 2 f

d under the Queensland Building Services Authority Act 1991 -
t

    

   
 

11. Is payment of a PLSL levy applicable to this application? (Refer 10 070 and the Advice below for more information)?

 

 

 

 

EM} No + tinte
{] Yes -
QFFICE USE ONLY (For use by the Assessment Manager / Private Center) (Optional)
{ i 1
. Receiving officers Reference t
Fee (3), Date received name numbers

 

 

 

 

 

 

 

 

NOTIFICATION OF ENGAGEMENT. OF PRIVATE CERTIFIER .

Pounci t have been engaged as the private certifier for the building work referred to in this application
Date of * . ct

engagement
@

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QLEAVE NOTIFICATION AND PAYMENT (lor completion by assessment manager or private cenifier if applicable)

 

> ee , To) baeneared
-Destripioh of tne work” é » Date paid 2

    
 

     

 

 

 

 

 

1

 

 

 

i

Privacy Statement
ke information collected on Form 3 wall be used by the Department of infrastructure and Planning (DIP) in accordance with che processing and assessment of your Apptiesiiaa,
Your personal details: wel not be disclosed for a purpose outside of the [DAS pre 1 except where required by legislation {including the Freedom of information Act 1992} er as
required by Parliament. This information may be stored ina DIP database. The information collected will be retained as requited by the Public Records Act 2002.

 

 

 

Advice for completing Part A

(General advice I

Building Act 1975 only, i.e. those applications requiring the compietion of Parts A and B only.

 

. Part A of IDAS Development Application Form 1 must be completed and accompany all development applications. The applicant is responsible
for answering all questions fully and correctly, unless following a response there is a stalement to go directly to another question. The
Assessment Manger may refuse to receive an application thal is not properly made. /

* The IDAS Assessment Checklist must also be completed for all development applications, other than those requiring assessment against the |

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0g SEP 2009