DA Form 1

Name of the heritage place:

 

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

pxNo

Decision under section 62 of the Transport Infrastructure Act 1994

  

23.15)

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)

“YSNo

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

~No
Note: See guidance materials at www planning.dsdmip. gid. goy.au for further information.

PART 8 — CHECKLIST AND APPLICANT DECLARATION

| have identified the assessment manager in question 15 and all relevant referral
requirement(s) in question 17 Yes ~
Note: See the Planning Regulation 2017 for referral requirements

 

If building work is associated with the proposed development, Parts 4to6 of DAForm2- {Yes
Building work details have been completed and attached to this development application Not applicable we

 

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 Yes ZZ -

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 al! aspects of this development application. For further 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 Yes

development permit is issued (see 27) Not applicable Yv.

 

 

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

ere 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: /t 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:

* 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

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

* 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