07/1836 - MCU - Detached House [As Published] · 132007.1836

INTEGRATED PLANNING ACT 1997 : : Part A, Version 2.4, 29 May 2008
Land owner's consent (i/appfcable) 20. Land owner's consent to the making of this application: ___

Namo Signature. Date

 

 

   

(I) “reconfiguration of a tr,
‘ay Wonon nd Dobw Nghia marl ih 9 ' (li) .
anal as defined inder the Coastal Protection end | yoo aaceccacceeeercoseeesenseees weet tenn ea sites seenens ceases sates beteeneenennas
 Managament Act 19080r 9°

{¥) work en ral condor nd detinod under the (ith

-Trensport indrastrictire Act. 1994.
“Soctton 818.1(2)(a) ofthe IPA provides that one
ldo’ consol equd fr ghar (Wy)
fompormy ERA. .

 

 

 

 

 

 

 

    
 

 

_ Ragource’ ‘entit ao 2H, Does: his application Involve a State resource prescribed under a regulation (other than involving
Sobtion 3.2:1(5) of tie IPA riquires er

of,
* frasource aniiterent be gtven tar enplications ‘at quanyy faterial on Stale coastal and under the Coastal Protection and Management Act 1995)?
Involve a proscribed St resource, : 0 - goto Q24 . DYES - go 022

.2.1(f OX aNi of thd IPA prescres ‘ :
aapiatton camutbe'akon tobe romans naa 22, This application is accompanted by evidence: (tick applicable box)

wihout evklonco oF to resouree onivemant (14) ofthe allocation of, or entitiement to, the resource - attach evidence and go to Q23(vi)

» Advice forcompteling G24 822 -
Fa et atte itd Pg CA) the chiefexecittive of the department administering the resource is satisfied the
Re 1 tho
@ rated by tho State Pepeotae oe iy of ried development Is ‘conalatent with ap allocation of, or entitement to, the resource go.

“devepmert application. .’ «

: ° C1 (fi). the chief executive of the department administering the resource Is satisfied the

. development application may procesd In the absence of an allocation of, or

oo, an . entitlement to, the resource ~ go fo 023 ‘
Advles for completing G23. 23, Eviderice of the resource entitement:
The infomation in (} = (v} 4s mandatory tf evidence 's

j

requled under G22 (ho (above, Ret} (i) | Resource entitlement / authority detalls __ (vi Offictat stamp of the department
The offical tamp of the Dépariment of Natural f oe administering the resource (if
Resouress, Mines and Water s mandatory where the," -

aplication votes any wate of rvertne quamty “ _ (i) Name of delegated officer a

material under tho Woter Act 2000,

tet
Section 3.2,1(5A) allows the resource manager to init

the time the avid be used, O23 tba F
tonekst be cues inetntes (ill) Position of sine officer

(iv) Signature of delegated officer

RE]
x4

Oi

        

 

 

 

 

(v) Date

{vi) = date of evidence ia

Assessment triggers EF 77124. Is the IDAS Assessment “gio completed and attached to this application?

 

 

"Wis checklist does not apply tte apres sel mh YES 8 ass8Sment manager may refuse fo accept this epptcation en the

the completion of Parts A and 8 of Ore Form only, , It
mmust be complated tor ail other applications. iy Heid that the application has not been properly made

 

Plans! drawings / reports t.4' _¢i 125. Plans/drawingsieports accompanying ‘this application:
5 7 t

: eal ellahaenpnewiuiewintnitehia Plan {Drawing ! Report Number, .2-|- Title «Date
manager, referral agancles and any person vewing
the application during public scrutiny oF public
rottication to understand the scope of the proposal
‘ond any potential Imoact.

 

 

 

 

 

 

 

 

 

 

PLEASE NOTE: The assessment manager may refuse lo accepl an application that, at the time of lodgement, fails to provide all applicable information required by Part A
and any other relevant part of Form 1.

OFFICE USE ONLY (appiicabio to assossment manager's)
[reo ogo set | 8/4 Jor [RPS Cu, [eee ov [i eae |
Notification of Engagement of Private Certifier (Optional forntaty-
To, Council, |have been engaged as the private Certifies for the building work referred to In this application.

 

Dateatengagement: / / Accreditation Number, _— Name, Signature: