Development Application part 1 of 2 - Cover Letter & IDAS Forms MCU13/0078

12. Is the payment of a portable long service leave levy applicable to this application? (Referto notes at the end
of this form for more information.)


~     N~o to question 14             ~     Yes



13. Has the portable long service leave levy been paid? (Refer to notes at the end of this form for more
information.)


~     No


o Yes-complete Table N and submit with this application the yellow local government/private certifier’s copy of the
      receipted QLeave form

Table N

Amount paid             Date paid          QLeave project number (6 digit number starting with A, B, E, L or P)

                        (dd/mm/yy)




14. Has the local government agreed to apply a superseded planning scheme to this application under section
96 of the Sustainable Planning Act 20097


~     No


o Yes-please provide details below

Name of local government                          Date of written notice given     Reference number of written notice given
                                                  by local government              by local government (if applicable)
                                                  (dd/mm/yy)




15. List below all of the forms and supporting information that accompany this application (Include all IDAS
forms, checklists, mandatory supporting information etc. that will be submitted as part of this application. Note: this
question does not apply for applications made online using Smart eDA.)

Description of attachment or title of attachment                                             Method of lodgement to
                                                                                             assessment manager


(1)Plans & specifications relevant to the proposed works.                                    Email for printing if required.


(2)IDAS Form 2                                                                               Email for printing if required.


(3)Engagement Agreement                                                                      Email for printing if required.




16. Applicant’s declaration


~ By making this application, I declare that all information in this application is true and correct (Note: it is unlawful to
provide false or misleading information.)




6                                                                                                 IDAS form 1-Application details
                                                                                                    Version 2.0 17 December 2012