Development Application for permit to damage vegetation - OPW13/0554

 Question 12
 .   The portable long service leave levy need not be paid when the application is m  e, 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
                                                                                                              For
     agency, on request from QLeave, or can be completed on the QLeave website at www.qleave.qld.gov.au.
     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 and/or 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 IDAS 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 2009) 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                                             I Reference numbers
  NOTIFICATION OF ENGAGEMENT OF A PRIVATE CERTIFIER

                                                                 Council. I have been engaged as the private certifier for the
   To
                                                             I   building work referred to in this application

                                                                               BSA Certification license          Building
   Date of engagement         Name                                                                                classificationls
                                                                               number




                                                                                                                 certifier if
  QLEAVE NOTIFICATION AND PAYMENT (For completion by assessment manager or private
  applicable.)
                                                                                                Date receipted
                                                                                                                    Name of officer
                                     QLeave project          Amount paid                        form sighted by
                                                                                   Date paid                        who sighted the
    Description of the work          number                  ($)                                assessment
                                                                                                                    form
                                                                                                manaqer




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




Depanment of State Development, Infrastruaure and Planning
PO Box 15009 City East Old 4002
tel13 OGOV (1374 68)
                                                                                                           /DAS form 1-Appllcatlon details
[email protected]
                                                                                                                  Version 3.0-1 July 2013
www.dsdip.qld.gov.au