DA Form 1 & Plan

 

C1 Listed on the Environmental Management Register (EMR) under the Environmental Protection Act 1994
EMR site identification: |

C1 Listed on the Contaminated Land Register (CLR) under the Environmental Protection Act 1994

CLR site identification:

 

 

 

 

Fey PUM a(-1eom- la atcy ds) le Moret Ti) mm LM OLLI STIG

We) ote ed ‘hroughout Que ind and are to b ntified correctly and accurately. For further information on easements and
how they may affect th posed development, see DA Forms Guide.

(J Yes — All easement locations, types and dimensions are included in plans submitted with this development |
application
LI No

PART 3 —- DEVELOPMENT DETAILS

 

Section 1 — Aspects of development
6.1) Provide details about the first development aspect
a) What is the type of development? {tick only one box)

   

 

 

 

 

 

 

C1 Material change of use ~~ [_] Reconfiguring a lot UJ Operational work C1 Building work

b) What is the approval type? (tick only one box)

PR.Development permit (1 Preliminary approval C Preliminary approval that includes a variation approval

c) What is the level of assessment?

pat Code assessment CJ Impact assessment (requires public notification)

d) Provide a brief description of the proposal (e.g. 6 unit apartment building defined as multi-unit dwelling, reconfiguration of 1 lot into 3
lots):

 

 

e) Relevant plans
Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms quide:

 

Refevant plans.
Py Relevant plans of the proposed development are attached to the development application
6 Provide deta O =) ond development aspe

a) What is the type of development? (tick only one bax)

 

 

 

 

 

CO Material change of use ~~ [[] Reconfiguring a lot C1 Operational work [1 Building work

b) What is the approval type? (tick only one box)

LD Development permit (Preliminary approval C1 Preliminary approval that includes a variation approval
c) What is the level of assessment?

[J Code assessment CJ Impact assessment (requires public notification)

 

d) Provide a brief description of the proposal (e.g. 6 unit apartment building defined as multi-unit dwelling, reconfiguration of 1 lot into 3
lots):

 

 

e) Relevant plans
Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms Guide:
Relevant plans.

CJ Relevant plans of the proposed development are attached to the development application
6.3) Additional aspects of development

C1 Additional aspects of development are relevant to this development application and the details for these aspects
that would be required under Part 3 Section 1 of this form have been attached to this development application

CJ Not required

 

 

 

 

 

Page 3
DA Form 1 — Development application details
Version 1.3— 28 September 2020