01.6 - Da Form 2 · 132007.616.05

| development application

O No -I, 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

O Notapplicable pips: Piatra! oes de Rete
Amount paid Date paid (dd/mm/yy) QLeave levy number (A, B or E)

|$

 

 

 

 

 

 

 

|

0 Yes — show cause or enforcement notice is attached
OO No

 

 

The proposed development is on a place entered in the Queensland heritage register or in a local
Oo government's Local Heritage Register. See the guidance provided at www.ehp.qld.gov.au about the
requirements in relation to the development of a Queensland heritage place

 

 

Name of the heritage place: | | Place ID: |

 

 

PART 4 — REFERRAL DETAILS

O Yes — the Referral checklist for building work is attached to this development application

& No — proceed to Part 5

 

 

0 Yes — referral response(s) received and listed below are attached to this development application

O No
Referral requirement

 

= agency | Date referral response

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

 

 

 

 

 

 

PART 5 — BUILDING WORK DETAILS

 

 

 

 

 

 

O Tick if the applicant is also the owner and proceed to 15). Otherwise, provide the following information.
Name(s) inchiduaner carpany full name) Walhalla Holdings Pty Itd a
Contact name (applicable for companies) a "Kathryn Taylor
| Postal address (P.O. Box or street address) c/o Tike Property Pty Ltd _ a
| PO Box 39
Suburb Noosa Heads | :

 

 

 

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DA Farm 2 — Navaianment Annlicatian dataile