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Lot Reconfiguration (1 Lot into 2) - RAL19/0030
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Relevant licence number(s) of chosen assessment
manager
QLeave notification and payment
Note: For completion by assessment manager if applicable
Description of the work
QLeave project number
Amount paid ($)
Date paid
Date receipted form sighted by assessment manager
Name of officer who sighted the form
Page 12
DA Form 1 - Development Application details
Version 1.1—22 JUNE 2018
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