0014C22C.001

INTEGRATED PLANNING ACT 1997                                                                                     Part D, Version 2.0, 4 October 2004

                                 Form 1        Development Application                                                                         idas

                                    Material                     change                      ofuse                                &
                       assessable against a local government's planning scheme                                                    Se           |

          ee
                                Completion of all applicable questions on Part D is mandatory for all applications involving assessment of a
                                         material change of use (MCU) assessable against a local governments planning scheme.
           Nature of the application              1.   This application is for: (tick 4 or both if appticabte)
           preeenaliniall amorses imine                  (-] Preliminary approval for a material change of use of premises including conceptual
           approval is astep in the approval orocese         design for any associated works that require approval under the planning scheme (ie.
           and does not authorise development to occur,      consideration of the proposal concepi)
                                                         AND/OR
  @                                                          Development permit for a material change of use of premises including conceptual
                                                             design for any associated works that require approval under the planning scheme.
           The subject land                       2,   How the subject land is identified in the planning scheme (name the zone, precinct etc.)
           the planning scheme against which the         Detached housing
           application will be assessed.
                                                  3.   Existing gross floor area: {if applicable}
                                                  4.   Are there any existing easements on the land?
                                                         J NO
                                                         1 YES - attach plans of the location and details of the purpose of the easement
            Material change of use details        5.   Details of the change to the use of the land: (eg. vacent land to shopping centre, house to apartment building,
                                                       vacant land to industry {tyre manufacturing) etc.)
                                                         Two dwellings
                                                  §.   WNuiiver of empioyees:           | N/A
                                                 :     Operating days and hours
@           Associated building works details (if 1g.  Site cover:       39% for each dwelling
            applicable)
            For the definition of “site cover’, “gross floor |9 Gross floor area: total - 416m?
            area” and “storey” go to the planning scheme | ~            .
               inst which the application will be                      .          .
            aessed.      ° epee                   10.  Number of on-site car parking spaces:
                                                  11.  Number of storeys / maximum height above natural ground:          two and eight metres
                                                   12. Number of employees
                                                   13. Hours and days the use will operate
            Associated operational works details | 14. Details of associated operational works (eg. landscaping, cut and fil, drainage, road works etc.)
             if applicable
               aa

                                                                         PLEASE NOTE
                                           This application cannot be accepted unless accompanied by Part A of Form 1.
                The assessment manager may refuse to accept an application that, at the time of lodgement, fails to provide all applicable information
                                                      requested by Part A and any other relevant part of Form 1.

            OFFICE USE ONLY (applicable to assessment manager)
                                                                       REFERENCE