27.05 UPDATE - Form1

   Yes – I acknowledge that a quarry material allocation notice must be obtained prior to commencing development
X No
Note: Contact the Department of Environment and Heritage Protection at www.ehp.qld.gov.au for further information.

Referable dams
23.11) Does this development application involve a referable dam required to be failure impact assessed under
section 343 of the Water Supply (Safety and Reliability) Act 2008 (the Water Supply Act)?
   Yes – the ‘Notice Accepting a Failure Impact Assessment’ from the chief executive administering the Water Supply
Act is attached to this development application
X No
Note: See guidance materials at www.dews.qld.gov.au for further information.

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?
    Yes – the following is included with this development application:
         Evidence the proposal meets the code for assessable development that is prescribed tidal work (only required if
       application involves prescribed tidal work)
           A certificate of title
X No
Note: See guidance materials at www.ehp.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?
   Yes – details of the heritage place are provided in the table below
X No
Note: See guidance materials at www.ehp.qld.gov.au for information requirements regarding development of Queensland heritage places.

Name of the heritage place:                                                     Place ID:
Brothels
23.14) Does this development application involve a material change of use for a brothel?
    Yes – this development application demonstrates how the proposal meets the code for a development application
for a brothel under Schedule 3 of the Prostitution Regulation 2014
X No
Decision under section 62 of the Transport Infrastructure Act 1994
23.15) 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)
X No

PART 8 – CHECKLIST AND APPLICANT DECLARATION
24) Development application checklist
I have identified the assessment manager in question 15 and all relevant referral
requirement(s) in question 17                                                                                    X Yes
Note: See the Planning Regulation 2017 for referral requirements
If building work is associated with the proposed development, Parts 4 to 6 of Form 2 –                              Yes
Building work details have been completed and attached to this development application                           X Not applicable
Supporting information addressing any applicable assessment benchmarks is with
development application
Note: This is a mandatory requirement and includes any relevant templates under question 23, a planning report   X 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.
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                                                                                                       DA Form 1 – Development Application details
                                                                                                                     Version 1.1— 22 JUNE 2018