Ida form 622052017 · OPW17/0180

Department of Infrastructure, Local Government and Planning

Table B
a) What is the nature of the operational work? (Tick all applicable boxes.)
[] Road works [-] Stormwater [-] Water infrastructure
[_] Drainage works [_] Earthworks ["] Sewerage infrastructure
(_] Landscaping [_]_ Signage [-] Clearing vegetation under the planning scheme

CY other—provide details Lew =

b) Is the.operational work necessary to facilitate the creation of new lots? (E.g. subdivision.)

No [] Yes—specify the number of lots being created

 

c) Are thére any current approvals associated with this application? (E.g. material change of use.)
No [] Yes—provide details below

         

List of approval reference/s

2. What is the dollar value of the proposed building work? $
(Inc GST, materials and labour.) i AOOO
3, What is the dollar value of the proposed operational work? $
(Inc GST, materials and labour.)

Mandatory supporting information

4. Confirm that the following mandatory supporting information accompanies this application

Mandatory supporting information Confirmation of | Method of
lodgement lodgement

All applications involving building work or operational work .
Asite plan drawn to an appropriate scale (1-100. 1:200 or 1:500 are ] = Eonfirmed
recommended scales) which shows the following:
¢ the location and site area of the land to which the application relates
(relevant land)
© the north point
e the boundaries of the relevant land
* the allotment layout showing existing lots, any proposed lots (including the
dimensions of those lots), existing or proposed road reserves, building
envelopes and existing or proposed open space (note: numbering is
required for al! lots)
® any existing or proposed easements on the relevant land and their
function
any access limitation strips
all existing and proposed roads and access points on the relevant land

Date approved (dd/mmi/yy)

Date approval lapses (dd/mmiyy)

  

 

 

 

 

 

   
 
 
 
 
 
  

 

IDAS form 6—-Building or operational work assessable
gainist 3 planning scheme
Version 3,1—3 August 2075