OPW14/0139 - Application for Operational Works - Private Jetty - 23 The Peninsula, Noosaville

    Questlon 12
    • The portable long service leave levy need not be paid when the application is made, but the Building and
      Construction Industry (Portable Long Service Leave) Act 1991 requires the levy to be paid before a development
      permit is issued.
    • Building and construction industry notification and payment forms are available from any Queensland post office or
      agency, on request from QLeave, or can be completed on the QLeave website at www.qleave.qld.gov.au. For
      further information contact QLeave on 1800803481 or visit www.qleave.qld.gov.au.


    Privacy-The    information collected in this form will be used by the Department of State Development, Infrastructure
    and Planning (DSDIP), assessment manager, referral agency andlor building certifier in accordance with the
    processing and assessment of your application. Your personal details should not be disclosed for a purpose outside of
    the JDAS process or the provisions about public access to planning and development information in the Sustainable
    Planning Act 2009, except where required by legislation (including the Right to Information Act 200rl) or as required by
    Parliament. This information may be stored in relevant databases. The information collected will be retained as
    required by the Public Records Act 2002.


    OFFICE USE ONLY

     Date received       ____________                           1   Reference numbers

    NOTIFICATION OF ENGAGEMENT OF A PRIVATE CERTIFIER

     To                                                             Council. I have be~n engaged as the private certifier for the

              ---------------- I
                                                                    building work referred to in this application

                                                                                  BSA Certification license          Building
     Dale of engagement                 Name
                                                                                  number                             classificationls




   QLEAVE NOTIFICATION AND PAYMENT (For completion                         by assessment     manager or private certifier     if
   applicable.)

                                                                                                   Date receipted
                                                                                                                       Name of officer
                                               QLeave project   Amount paid                        form sighted by
     Description of the work                                                          Date paid                        who sighted the
                                               number           ($)                                assessment
                                                                                                                       form
                                                                                                   manaoer




   The Sustainable Pfanning Act 2009 is administered by the Department of State Development, Infrastructure and
   Planning. This form and all other required application materials should be sent to your assessment manager and any
   referral agency.




Department of State Development, Infrastructure and Planning
PO Box 15009 City east Old 4002
10113 OGOV (13 74 68)
[email protected]                                                                                      IDAS form I-Application details
                                                                                                                  Version3.0-1 July 2013
www.dsdlp.qld.gov.au