MCU11/0033 Development Application - Part 1 of 2 Cover Letter - IDAS Form 1 and 5 Checklist 1 and Part 2 - 6 Piper St Peregian Beach

Privacy-the information collected in this form will be used by the Department of Infrastructure and Planning (DIP) in
accordance with the processing and assessment of your application. Your personal details will not be disclosed for a purpose
outside of the IDAS process, except where required by legislation (including the Right to /nformationAct2009) or as required
by Parliament. This information may be stored in a departmental database. The information collected will be retained as
required by the Public Records Act 2002. __


                                 )ornent uou
OFFICE USE ONLY
 Date received                      1 FEB 2               Reference numbers

NOTIFICATION OF ENGAGEMENT OF A PRIVATE CERTIFIER
 To                                        Council. I have been engaged as the private certifier for the building work referred
                                           to in this application


                                                                                                          Building
Date of engagement        Name                                         BSA Certification license number
                                                                                                          classification/s




QLEAVE NOTIFICATION AND PAYMENT (for completion by assessment manager or private certifier if applicable)
                                                                                         Date receipted
                                  QLeave Project        Amount paid                     form sighted by    Name of officer who
Description of the work                                                    Date paid
                                  Number                ($)                             assessment         sighted the form
                                                                                         manager




 The Sustainable PlanningAct2009 (SPA) is administered by the Department of Infrastructure and Planning. This form and
 all other required application materials should be sent to your assessment manager and any referral agencies.



                                                                                                            -IDAS form i
                                                                                            Version r.o 18December 2o0U