Costelloe - DA Form 1

Page 2

PART 2 —LOCATION DETAILS D>

8) Location of the premises (complete 3.1) or 3.2), and.3.3).as applicable)
Note: Provide details below. and.attach:a site:plan for any or all premises part.of the:development application. For further: information; see DA.

Forms: Guide: Relevant:plans.
3:1) Street address and.lot.on plan

 

CU Street address AND lot on plan (ai! ots must be listed), or

[J Street address AND lot on plan for an adjoining or adjacent property of the premises (appropriate for development in
water but adjoining or adjacent to land e.g. jetty, pontoon. All lots must be listed).

 

 

 

 

 

 

 

Unit No. | Street No. | Street Name and Type Suburb
a) Et 1.35 | Gove., Balli Crk Real | Coovo4y
Postcode | Lot No. Plan Type’and Number (e.g. RP, SP) Local Governfent Area(s)
AXSE3 2 ISBasour Noosee
Unit No. Street No. | Street Name and Type Suburb
b)
Postcode | Lot No. Plan Type and Number (e.g. RP, SP) Local Government Area(s)

 

 

 

 

 

3.2) Coordinates of premises (appropriate for.development in.remote areas, over part of a lot.or in water not adjoining or adjacent fo land,

e.g. channel dredging in: Moreton: Bay)
Note: Place each set of coordinates in a separate row:

CJ Coordinates of premises by longitude and latitude
Longitude(s) Latitude(s) Datum Local Government Area(s) (if applicable)

C1 wese4
C1 GDAe4

CD Other:

Easting(s) Northing(s) Zone Ref. | Datum Local Government Area(s) (if applicable)
54 L] wese4
55 C] GDA94
(56 (1 Other:

 

 

 

 

 

(1 Coordinates of premises by easting and northing

 

 

 

 

 

 

 

3.3) Additional premises

C Additional premises are relevant to this development application and the details of these premises have been
attached in a schedule to this development application

Not required

(J In or adjacent to a water body or watercourse or in or above an aquifer
Name of water body, watercourse or aquifer: |
C1 On strategic port land under the Transport Infrastructure Act 1994

 

 

 

 

 

Lot on plan description of strategic port land:

Name of port authority for the lot:

CJ Ina tidal area

Name of local government for the tidal area (if applicable):
Name of port authority for tidal area (if applicable)

 

 

 

 

 

 

 

 

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DA Form 1 — Development application details
Version 1.6— 2 August 2024

Page 3

a
Z

 

(J On airport land under the Airport Assets (Restructuring and Disposal) Act 2008

Name of airport: |

(7 Listed on the Environmental Management Register (EMR) under the Environmental Protection Act 1994
EMR site identification: |

(J Listed on the Contaminated Land Register (CLR) under the Environmental Protection Act 1994

CLR site identification: |

 

 

 

 

 

 

 

5) Are there any existing easements over the premises?.

Note: Easement uses vary. throughout Queensiand-and are to be identified'correctly. and accurately. For further-information on easements and
how they. may. affect.the proposed development, see. DA: Forms Guide.

C1 Yes — All easement locations, types and dimensions are included in plans submitted with this development

 

application

 

7] No
PART 3 — DEVELOPMENT DETAILS <A

Section 1 — Aspects of development
6.1) :Rrovide details about the first development:aspect
a) What is the type of development? (tick only one. box)

 

 

 

 

 

 

 

(J Material change of use —_[_] Reconfiguring a lot (I Operational work (Building work

b) What is the approval type? (tick only one box)

i] Development permit (J Preliminary approval (] Preliminary approval that includes a variation approval

c) What is the level of assessment? — : : :

LA’Code assessment Oo Impact assessment (requires public notification)

d) Provide a brief description.of the Proposal (e.g. 6-unit apartment building defined as. multi-unit aneting. reconfiguration Of 1 Jot into 3
Jots): : | CPs &

 

Relocthunn Wa Crd $$ OVEN

e) Relevant plans
Note: Relevant plans are required to be submitted forall aspects of this development application. For further. information, see DA Forms quide:
Relevant plans.

[4] Relevant plans of the proposed development are attached to the development application
6.2): Provide details about the second elleeen suse

 

 

     

a) What is the type of development? (tick only one box) :
(] Material change of use [[] Reconfiguring a lot (J Operational work (1 Building work

 

 

 

 

 

b) What is the approval type? (tick only one box) :

LJ Development permit ( Preliminary approval O Preliminary approval that includes a variation approval
c) What.is the level of assessment? . oes oe

(J Code assessment (J impact assessment (requires public notification)

 

d) Provide a brief description of the proposal (2.9.6 unit apartment building defined as multi-unit dwelling, reconfiguration of 1 Jot into 3
lots):

 

 

e) Relevant plans
Note. Relevant plans are required to be submitted for all aspects of this development application, For further information, see DA Forms Guide:
Relevant plans,

_] Relevant plans of the proposed development are attached to the development application

 

 

 

 

? Queensiand
Government

 

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6:3) Rhone aspects of development

(J Additional aspects of development are relevant to this development application and the details for these aspects
that would be required under Part 3 Section 1 of this form have been attached to this development application

(I Not required
6.4) |s the application for State facilitated development?
(1 Yes - Has a notice of declaration been given by the Minister?

CI No

 

Section 2 — Further development details
7) Does ite proposed development application involve any, of the following?

 

 

 

 

Material change of use (1 Yes — complete division 1 if assessable against a local planning instrument
Reconfiguring a lot (J Yes ~ complete division 2

Operational work CO Yes — complete division 3

Building work C1 Yes — complete DA Form 2 — Building work details

 

 

 

Division 1 — Material change of use

Note: This division is only required to be completed if any part of the development application involves a material change of use assessable against a
local planning instrument.

8.1) Describe the proposed material change of use

 

Provide a general description of the Provide the planning scheme definition | Number of dwelling | Gross floor
proposed use (include each definition in a new row) units (if applicable) area (m?)
(if applicable)

 

 

 

 

 

 

 

8.2) Does the proposed use involve the:use of existing buildings on the premises?

(Yes
M] No

8:3) Does the proposed development relate to temporary accepted development under .the Planning Regulation?
C1 Yes - provide details below or include details in a schedule to this development application

[A No

Provide a general description of the temporary accepted development Specify the stated period dates
under the Planning Regulation

 

 

 

 

 

 

 

 

 

Division 2 — Reconfiguring a lot
Note: This division is only required to be completed if any part of the development application involves reconfiguring a lot.
9.1) What is the total number of existing lots making up the premises”.

   

 

9.2) What is the nature of the lot reconfiguration? (tick all applicable. boxes)

 

 

 

(1 Subdivision (complete 10) (] Dividing land into parts by agreement (complete 11)
(1 Boundary realignment (complete 12) (J Creating or changing an easement giving access to a lot
from a constructed road (complete 13)

 

 

Queensland
Government

 

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¢

410) Subdivision

 

10.1) For this development; how many lots are being created and what is the intended use of those lots:
Intended use of lots created Residential Commercial industrial Other, please specify:

 

 

 

 

 

 

Number of lots created

10.2) Will the subdivision be staged?
(1 Yes — provide additional details below
[No

How many stages will the works include?

What stage(s) will this development application
apply to?

 

 

 

 

 

 

 

 

14):Dividing land:into: parts by agreement — how many parts are being created and what is the intended use of the

    

parts.
Intended use of parts created Residential Commercial Industrial Other, please specify:

 

 

 

 

Number of parts created

 

 

 

12) Boundary. realignment

 

12.1) What are the current and proposed areas for each lot comprising the: premises?
Current lot Proposed lot
Lot on plan description Area (m?) Lot on plan description Area (m?)

 

 

 

 

 

 

 

 

-12:2)-Whatis the-reason ‘for the boundary realignment? =~

 

13) What are the dimensions and.nature.of-any existing easements being changed and/or any proposed easement?
(attach schedule. if:there are: more than two'easements)

Existing or Width (m) | Length (m) | Purpose of the easement? (e.g. Identify the land/lot(s)
proposed? pedestrian access) benefitted by the easement

 

 

 

 

 

 

 

 

 

 

Division 3 ~ Operational work
Note: This division is only required to be completed if an

   
     
   

part of the development application involves op erational work.
14.1) Whatis the nature of the operational work? :

(Road work (J Stormwater (7 Water infrastructure

     
     
       
  

 

(1 Drainage work CJ Earthworks (2 Sewage infrastructure
(Landscaping CJ Signage (CO Clearing vegetation
[4 Other — please specify: Crests over worl = reloce

     
 
   

  

14.2).1s the operational work necessary to facilitate the creation of new lots? (e.g. subdivision)
(7 Yes — specify number of new lots:

| No

 

Queensland
Government

 

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14.3) What is the monetary value of the proposed operational work? (include GST, materials and labour)
$
PART 4 — ASSESSMENT MANAGER DETAILS

15) Identify the assessment manager(s) who will be assessing this development application

 

 

 

16) Has the local government agreed to apply a superseded planning scheme for this development application?

(I Yes — a copy of the decision notice is attached to this development application

(] The local government is taken to have agreed to the superseded planning scheme request — relevant documents
attached

[No

 

PART 5 — REFERRAL DETAILS

17) Does this development-application include any aspects that have any referral requirements?
Note: A development application will require referral.if prescribed: by the Planning Regulation:20177-

[X1No, there are no referral requirements relevant to any development aspects identified in this development
application — proceed to Part 6

Matters requiring referral to the Chief Executive of the Planning Act 2016:

(J Clearing native vegetation

(J Contaminated land (unexploded ordnance)

CZ Environmentally relevant activities (ERA) (only if the ERA has not been devolved to a local government)

(J Fisheries — aquaculture

( Fisheries — declared fish habitat area

(J Fisheries — marine plants

CJ Fisheries — waterway barrier works

(J Hazardous chemical facilities

(1) Heritage places — Queensland heritage place (on or near a Queenstand heritage place)

(1 Infrastructure-related referrals — designated premises

(J Infrastructure-related referrals — state transport infrastructure

(1 Infrastructure-related referrals — State transport corridor and future State transport corridor

(J Infrastructure-related referrals — State-controlled transport tunnels and future state-controlled transport tunnels

(1 Infrastructure-related referrals — near a state-controlled road intersection

(J Koala habitat in SEQ region — interfering with koala habitat in koala habitat areas outside koala priority areas

C1 Koala habitat in SEQ region — key resource areas

(J Ports ~ Brisbane core port land — near a State transport corridor or future State transport corridor

(J Ports — Brisbane core port land ~ environmentally relevant activity (ERA)

(1 Ports — Brisbane core port land — tidal works or work in a coastal management district

(1 Ports ~ Brisbane core port land — hazardous chemical facility

(J Ports — Brisbane core port land — taking or interfering with water

(J Ports — Brisbane core port land — referable dams

(2 Ports — Brisbane core port land ~ fisheries

(7 Ports — Land within Port of Brisbane’s port limits (below high-water mark)

CJ SEQ development area

CC] SEQ regional landscape and rural production area or SEQ rural living area — tourist activity or sport and
recreation activity

(C] SEQ regional landscape and rural production area or SEQ rural living area — community activity
(1 SEQ regional landscape and rural production area or SEQ rural living area — indoor recreation
( SEQ regional landscape and rural production area or SEQ rural living area — urban activity

(1 SEQ regional landscape and rural production area or SEQ rural living area — combined use

(J SEQ northern inter-urban break — tourist activity or sport and recreation activity

    
   

 

 

 

 

  
   

oD Queensland
ee’ Government

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(J SEQ northern inter-urban break — community activity

CJ SEQ northern inter-urban break — indoor recreation

(1 SEQ northern inter-urban break — urban activity

(J SEQ northern inter-urban break — combined use

C1] Tidal works or works in a coastal management district

(J Reconfiguring a lot in a coastal management district or for a canal
(J Erosion prone area in a coastal management district

(J Urban design

(-] Water-related development — taking or interfering with water

(7 Water-related development - removing quarry material (from a watercourse or lake)
(J Water-related development — referable dams

(J Water-related development —levees (category 3 levees only)

(J Wetland protection area

Matters requiring referral to the local government:

C) Airport tand

(7 Environmentally relevant activities (ERA) (only if the ERA has been devolved to local government)

(] Heritage places — Local heritage places

Matters requiring referral to the Chief Executive of the distribution entity or transmission entity:
(J Infrastructure-related referrals — Electricity infrastructure

 

 

 

Matters requiring referral to:

e The Chief Executive of the holder of the licence, if not an individual
e The holder of the licence, if the holder of the licence is an individual
(J Infrastructure-related referrals — Oil and gas infrastructure

 

Matters requiring referral to the Brisbane City Council:

C1 Ports - Brisbane core port land

Matters requiring referral to the Minister responsible for administering the Transport Infrastructure Act 1994:
(J Ports ~ Brisbane core port land (where inconsistent with the Brisbane port LUP for transport reasons)

(J Ports ~ Strategic port land

Maiters requiring referral to the relevant port operator, if applicant is not port operator:

C Ports — Land within Port of Brisbane’s port limits (below high-water mark)

 

 

 

Matters requiring referral to the Chief Executive of the relevant port authority:
L] Ports — Land within limits of another port (below high-water mark)

 

Matters requiring referral to the Gold Coast Waterways Authority:
(A Tidal works or work in a coastal management district (in Gold Coast waters)

 

Matters requiring referral to the Queensland Fire and Emergency Service:
(1 Tidal works or work in a coastal management district (involving a marina (more than six vessel berths)

18) Has any.referral agency. provided a referral response for this development application? :

(J Yes — referral response(s) received and listed below are attached to this development application
[CI No

Referral requirement Referral agency Date of referral response

 

 

 

 

 

 

 

Identify and describe any changes made to the proposed development application that was the subject of the
referral response and this development application, or include details in a schedule to this development application
(if applicable).

 

 

 

 

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DA Form 1 — Development application details
Version 1.6— 2 August 2024

Page 8

PART 6 — INFORMATION REQUEST >

 
   

19) Information request under the DA Rules

maa agree to receive an information request if determined necessary for this development application
(1 | do not agree to accept an information request for this development application
Note: By not agreeing to accept an information request |, the applicant, acknowledge:

e that this development application will be assessed and decided based on the information provided when making this development
application and the assessment manager and any referral agencies relevant to the development application are not obligated under the DA
Rules to accept any additional information provided by the applicant for the development application unless agreed to by the relevant
parties

e Part 3 under Chapter 1 of the DA Rules will still apply if the application is an application listed under section 11.3 of the DA Rules or

e Part 2under Chapter 2 of the DA Rules will still apply if the application is for state facilitated development

Further advice about information requests is contained in the DA Forms Guide.

 

PART 7 — FURTHER DETAILS

 

20) Are there any associated development applications or. fiat approvals 2 (eig- a preliminary approval)
CJ Yes — provide details below or include details in a schedule to this development application

ha No

 

List of approval/development Reference number Date Assessment
application references manager

(Approval
(J Development application

C1 Approval
(] Development application

 

 

 

 

 

 

24) Has the portable long service leave levy been paid? (only applicable to development applications involving building work or

eee eM eshd)
(1 Yes — a copy of the receipted QLeave form is attached to this development application

(J No - |, the applicant will provide evidence that the portable long service leave levy has been paid before the
assessment manager decides the development application. | acknowledge that the assessment manager may
give a development approval only if | provide evidence that the portable long service leave levy has been paid

(J Not applicable (e.g. building and construction work is less than $150,000 excluding GST)
Amount paid Date paid (dd/mm/yy) QLeave levy number (A, B or E)
$

 

 

 

 

 

 

22) Is this development application in response to a'show: cause: notice or required as a result of an enforcement

notice?

 

(1 Yes — show cause or enforcement notice is attached

[e'No

 

 

 

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DA Form 1 ~ Development application details
Version 1.6— 2 August 2024

Page 9

Pee) ai esse sel ueuncre(Ulkclane ny

Environmentally relevant.act

23.1).Is this: development application also.taken to be. an application for an environmental authority foran

Environmentally Relevant Activity, (ERA) under section 115 of the Environmental Protection Act 1994?

(J Yes — the required attachment (form ESR/2015/1791) for an application for an environmental authority
accompanies this development application, and details are provided in the table below

La'No

Note: Application for an environmental authority can be found by searching “ESR/2015/1791" as a search term at www.qld.gov.au. An ERA

requires an environmental authority to operate. See www.business.qid.gov.au for further information.

 

 

Proposed ERA number: Proposed ERA threshold:

 

 

Proposed ERA name:

 

 

 

 

(J Multiple ERAs are applicable to this development application and the details have been attached in a schedule to
this development application.

Hazardous chemical facilities

 

23.2) Is this development application for a hazardous chemical facility?

(1 Yes — Form 536: Notification of a facility exceeding 10% of schedule 15 threshold is attached to this development
application

[No

Note: See www. business. qid.gov.au for further information about hazardous chemical notifications.

Clearing native vegetation : :

23,3) Does this development application involve clearing native vegetation that: requires written confirmation that
the-chief executive of the Vegetation Management Act 1999 is satisfied the clearing is for a relevant purpose under
section 22A of the Vegetation Management Act-1999?.

(J Yes ~ this development application includes written confirmation from the chief executive of the Vegetation
Management Act 1999 (822A determination)

EZ No

Note: 1. Where a development application for operational work or material change of use requires a s22A determination and this is not included,
the development application is prohibited development.
2. See htips://www.ald.gov.au/environmenifand/vegetation/applying for further information on how to obtain a s22A determination.

 

 

Environmental offsets

23.4) ls this development application taken to be a prescribed activity that may have a significant residual impact on
a prescribed environmental matter under the Environmental Offsets Act 2014?

(1 Yes — | acknowledge that an environmental offset must be provided for any prescribed activity assessed as
having a significant residual impact on a prescribed environmental matter

fut No

Note: The environmental offset section of the Queensland Government's website can be accessed at www.qld.gov.au for further information on
environmental offsets.

Koala habitat in SEQ Region

 

 

23:5) Does this development application involve.a material change of use; reconfiguring a lot or operational work
which is assessable development under Schedule 10, Part 10 of the Planning Regulation 2017?

 

(1 Yes — the development application involves premises in the koala habitat area in the koala priority area
(] Yes — the development application involves premises in the koala habitat area outside the koala priority area

EANo

Note: If a koala habitat area determination has been obtained for this premises and is current over the land, it should be provided as part of this
development application. See koala habitat area guidance materials at www.desi.gid.gov.au for further information.

 

 

   

   
   

es
ae 4 Queensland
soe Government

  

Page 10

Water resources

23.6):Does this development application. involve.taking or interfering with underground water.through an

artesian or subartesian bore, taking or interfering with water ina watercourse, lake or spring, or taking
overland flow water under the Water Act 2000?

 

(1 Yes — the relevant template is completed and attached to this development application and | acknowledge that a
relevant authorisation or licence under the Water Act 2000 may be required prior to commencing development

[et'No

Note: Contact the Department of Resources at www.resources. qid.gov.au for further information.

DA templates are available from planning.statedevelopment.gid.gov.au. ff the development application involves:
«Taking or interfering with underground water through an artesian or subartesian bore: complete DA Form 1 Template 1
« — Taking or interfering with water in a watercourse, lake or spring: complete DA Form1 Template 2

° Taking overland flow water: complete DA Form 7 Template 3.

 

 

n involve waterway barrier works
(C1 Yes — the relevant template is completed and attached to this development application

MI No

DA templates are available from planning.statedevelopment.gid.gov.au. For a development application involving waterway barrier works,
complete DA Form 1 Template 4.

 

 

   

Marine activities

723.6) Does:this elesica Application involve aquaculture, works: within-a: declared fish habitat Pre:
removal, disturbance or destruction of marine plants?

(1 Yes — an associated resource allocation authority is attached to this development application, if required under
the Fisheries Act 1994

[No
Note: See guidance materials at www.dat.gid.gov.au for further information.
Quarry materials from ‘a:watercourse or lake

23.9) Does this development application involve the removal of quarry materials from a watercourse or lake
under the Water Act:20002

C1 Yes ~ | acknowledge that a quarry material allocation notice must be obtained prior to commencing development
[VM No

Note: Contact the Department of Resources at www.resources.gid.gov.au_and www.business.gid.gov.au for further information.

Quarry. materials from land under. tidal waters

 

 

23.10) Does this development application:involve the removal of quarry materials from land under tidal water
under the Coastal Protection and: Management Act 1995?

(1 Yes — | acknowledge that a quarry material allocation notice must be obtained prior to commencing development
[No

Note: Contact the Department of Environment, Science and Innovation at www.desi.qid.gov.au for further information.

Referable dams

23.11) Does this development application involve a referable dam required tobe failure impact assessed under
section 343 of the Water Supply (Safety and. Reliability) Act/2008 (the Water Supply Act)?

(J Yes — the ‘Notice Accepting a Failure Impact Assessment’ from the chief executive administering the Water
Supply Act is attached to this development application
No

Note: See guidance materials at www.resources.qid.gov.au for further information.

 

Queensland
Government

 

Page 11

Tidal.work or development within-a coastal: management district

23.12) Does this development application involve tidal work or development in a coastal management district?

 

(J Yes — the following is included with this development application:

(1) Evidence the proposal meets the code for assessable development that is prescribed tidal work (only required
if application involves prescribed tidal work)

CO Acertificate of title

[A No

Note: See guidance materials at www.desi.qld.gov.au for further information.
Queensland and local heritage places

   

23:13) Does this development application propose development on or adjoining a place entered in the Queensland
heritage register: or on a place entered in a local government's Local Heritage Register?

(JJ Yes — detaiis of the heritage place are provided in the table below

[No

Note: See guidance materials at www.desi.qid.gov.au for information requirements regarding development of Queensland heritage places.

For a heritage place that has cultural heritage significance as a local heritage place and a Queensland heritage place, provisions are in place
under the Planning Act 2016 that limit a local categorising instrument from including an assessment benchmark about the effect or impact of,
development on the stated cultural heritage significance of that place. See guidance materials at www.planning. statedevelopment.qidgov.au for
information regarding assessment of Queensland heritage places.

 

Name of the heritage place: Place ID:

Decision under section 62 of the Transport.infrastructure Act 1994
23.14) Does this development application involve new or changed access to a state-controlled road?

 

(Yes — this application will be taken to be an application for a decision under section 62 of the Transport
Infrastructure Act 1994 (subject to the conditions in section 75 of the Transport Infrastructure Act 1994 being
satisfied)

MI No
Waikable neighbourhoods assessment. benchmarks under Schedule 12A of the Planning Regulation

23.15) Does this development application involve reconfiguring a lot into 2 or more lots in certain sel zones
-(except rural-residential zones),- where at least one:road:is created or extended? —- e

(J Yes — Schedule 12A is applicable to the development application and the assessment benchmarks contained in
schedule 12A have been considered

[A'No

Note: See guidance materials at www.planning,statedevelopment.gid.gov.au for further information.

 

 

 

 

PART 8 — CHECKLIST AND APPLICANT DECLARATION

24)-Development applica ace

| have identified the assessment manager in question 15 and all relevant referral

requirement(s) in question 17 Cl Yes

Note: See the Planning Regulation 2017 for referral requirements

if building work is associated with the proposed development, Parts 4 to 6 of DAForm2- [] Yes

Building work details have been completed and attached to this development application (I Not applicable

   

 

 

Supporting information addressing any applicable assessment benchmarks is with the
development application

Note: This is a mandatory requirement and includes any relevant templates under question 23, a planning report 0 Yes
and any technical reports required by the relevant categorising instruments (e.g. local government planning
schemes, State Planning Policy, State Development Assessment Provisions). For further information, see DA

Forms Guide: Planning Report Template.
Relevant plans of the development are attached to this development application

 

 

 

 

Note: Relevant plans are required to be submitted for all aspects of this development application. For further id Yes

information, see DA Forms Guide: Relevant plans.

The portable long service leave levy for QLeave has been paid, or will be paid before a C1 Yes
development permit is issued (see 27) [44 Not applicable

 

Queensland
Government

 

Page 12

25) Applicant declaration

By making this development application, | declare that all information in this development application is true and
correct

wi Where an email address is provided in Part 1 of this form, | consent to receive future electronic communications
from the assessment manager and any referral agency for the development application where written information
is required or permitted pursuant to sections 11 and 12 of the Electronic Transactions Act 2001

Note: It is unlawful to intentionally provide false or misleading information.

Privacy — Personal information collected in this form will be used by the assessment manager and/or chosen

assessment manager, any relevant referral agency and/or building certifier (including any professional advisers

which may be engaged by those entities) while processing, assessing and deciding the development application.

All information relating to this development application may be available for inspection and purchase, and/or

published on the assessment manager’s and/or referral agency's website.

Personal information will not be disclosed for a purpose unrelated to the Planning Act 2016, Planning

Regulation 2017 and the DA Rules except where:

e such disclosure is in accordance with the provisions about public access to documents contained in the Planning
Act 2016 and the Planning Regulation 2017, and the access rules made under the Planning Act 2016 and
Planning Regulation 2017; or

e required by other legislation (including the Right to Information Act 2009); or

e otherwise required by law.

This information may be stored in relevant databases. The information collected will be retained as required by the
Public Records Act 2002.

 

 

 

 

 

PART 9 — FOR COMPLETION OF THE ASSESSMENT MANAGER -— FOR OFFICE
USE ONLY

Date received: [ti‘éCézd Reference number(s): |
Notification of engagement of:alternative assessment manager.

Prescribed assessment manager

 

 

Name of chosen assessment manager
Date chosen assessment manager engaged

 

 

Contact number of chosen assessment manager

Relevant licence number(s) of chosen assessment
manager

Qkeave notification and payment

Note: For completion by assessment manager. if. applicable
Description of the work
QLeave project number

Amount paid ($) | Date paid (dd/mm/yy) |
Date receipted form sighted by assessment manager

 

 

 

 

 

 

 

 

 

Name of officer who sighted the form

 

 

 

 

° Page 12
DA Form 1 — Development application details
Version 1.6— 2 August 2024