Form 1 - Development application details - 125 Cooroy Belli Creek Rd, Cooroy

 □ SEQ northern inter-urban break - community activity
 □ SEQ northern inter-urban break - indoor recreation
 □ SEQ northern inter-urban break - urban activity
 □ SEQ northern inter-urban break - combined use
 □ Tidal works or works in a coastal management district                                                                    /
 □ Reconfiguring a lot in a coastal management district or for a canal                                                  /
 □ Erosion prone area in a coastal management district                                                              /
 □ Urban design                                                                                                   ,/
 □ Water-related development - taking or interfering with water                                               /
 □ Water-related development - removing quarry material (from a watercourse or lake)                      /
 □ Water-related development - referable dams                                                         /
 □ Water-related development -levees (category 3 levees only)                                        /
 □ Wetland protection area                                                                       /

 Matters requiring referral to the local government:                                         /
 □ Airport land
 □ Environmentally relevant activities (ERA) (only if the ERA has been devolved to local Government)
□ Heritage places - Local heritage places______________________________ /
Matters requiring referral to the Chief Executive of the distribution entity or transmission entity:
□ Infrastructure-related referrals - Electricity infrastructure            /

Matters requiring referral to:
 •     The Chief Executive of the holder of the licence, if not an individual
•  The holder of the licence, if the holder of the licence is an indiyldual
□ Infrastructure-related referrals - Oil and gas infrastructure    /____________________________

Matters requiring referral to the Brisbane City Council:   /
□ Ports - Brisbane core port land________________________ /___________________
Matters requiring referral to the Minister responsible for administering the Transport Infrastructure Act 1994\
I I Ports — Brisbane core port land (where inconsistent with the Brisbane port LUP for transport reasons)
□ Ports - Strategic port land                                 /
Matters requiring referral to the relevant port operator, if applicant is not port operator:
□ Ports - Land within Port of Brisbane’s port limits (fielow high-water mark)

Matters requiring referral to the Chief Executive of the relevant port authority:
□ Ports - Land within limits of another port (below high-water mark)

Matters requiring referral to the Gold Coast Waterways Authority:
□ Tidal works or work in a coastal management district (in Gold Coast waters)

Matters requiring referral to the Queensland Fire and Emergency Service:
□ Tidal works or work in a coastal management district (involving a marina (more than six vessel berths))


18) Has any referral agency provided a referral response for this development application?
□ Yes - referral response(s) received and listed below are attached to this development application
□ No
Referral requirement                                              Referral agency                      Date of referral response




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




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                                                                                          DA Form 1 - Development application details
                                                                                                        Version 1.6— 2 August 2024