Revised DA Form 1

 

C Listed on the Environmental Management Register (EMR) under the Environmental Protection Act 1994

EMR site identification:

(1 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?

rem ement uses vary throughout Queensland and are to be identitied correctly and accurately »r further information on easements and
ff they may affect the proposed development, see DA Forms Guide

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

 

[No
PART 3 —- DEVELOPMENT DETAILS

Section 1 — Aspects of development

6,1) Provide details about the first development aspect

 

 

a) What is the type of development? (tick only one box) y
L) Material change of use CJ Reconfiguring a lot fWOperational work CJ Building work
b) What is the approval type? (tick only one box)

Development permit (J Preliminary approval (J Preliminary approval that includes

a variation approval

 

c) What is the level of assessment?

 

(J Code assessment LJ Impact assessment (requires public notification)
d) Provide a brief description of the proposal (e.g. 6 unit apartment building defined as multi-unit dwelling, reconfiguration of 1 lot into 3
lots):

 

Crossover Ayplica Sion

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.
A na
[M Relevant plans of the Proposed development are attached to the development application

6.2) Provide details about the second development aspect
a) What is the type of development? (tick only one box) 4
LJ Material change of use (J Reconfiguring a lot [4 Operational work C Building work

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

evelopment permit L) Preliminary approval C] Preliminary approy;
approval

c) What is the level of assessment?
(Code assessment LJ Impact assessment (requireS public notification)

d) Provide a brief description of the proposal (e.g. 6 unitapSrtment building defined as multi-unit dwelling, reconfiguration of 1 lot into 3
lots):

 

  
 
 

includes a variation

 

 

    
     

Cover Applicaton

quired to be submitted for all aspects of this development application. For further information, see DA Forms Guide:

e) Relevant plans
Note: Relevant plans ar,
Relevant plans.

Oo Relev

A

plans of the proposed development are attached to the development application

 

 

 

Page 3
DA Form 1 — Development Application details
Version 1.1— 22 JUNF 2018