Development Application part 1 IDAS Forms MCU13/0052

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 f2,:’II! the payment of a portable long service leave levy applicable to ttiis application? (Refer tobnotes at~the end~’
 of t~is’form for more information.)                                   Cl  ..~’A             ’,_          ,
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 r:g]   No-go to question 14                                   DYes
        iii

                                                ng:S rvice "leave’levy been paid? (Refer to notes~atothe: nd of this form-for more~
                                       II’Ii
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 13. Has the portable 10                                                                                                                                         ~~     ,’I :
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 information.)
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 r:g]   No


 D      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 (6digit number starting with A, B, E, L or P)

         ...
                                               (
                                               dd/mm/yy)
         .    .




 14. Hasthelocalgovernment agreed to apply a superseded planning scheme to this application under section
 96 of the Sustainable Planning Act 20091                                                                           IR




 r:g]   No


 D      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, mand atory supporting information etc. that will be submitted as part of this application. Note: this
                                                                                                                                                      a
  question does not apply for applications made online using Smart eDA.)


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


 IDAS Form 1 & 5                                                                                                         Mail

 Five (5)copies of the PIanning Report and Attachments                                                                   Mail

 Owners Consent                                                                                                          Mail


 Covering Letter                                                                                                         Mail

 Electronic Copy of Planning Report (CD Copy)                                                                            Mail




 r:g] 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 17December 2012