09/1583 - Op Works - Jetty [As Published] · 142009.1583

INTEGRATED PLANNING ACT 1997

 

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‘Attachments and supporting information (Complete Tablet - ~ Use a separate row for each type of atlachment or information, including information required '
Sunder this Part) Please ensure al documentation submitted with this form, inchuting other Paris of Form 1, or owner's consent, etc, are securely attached to this Part of the Form. ‘
bs -

Part A, Version 3.1, 3 March 2008

 

 

 

 

 

 

 

 

 

 

Description of attachment or information .

Table | (29 Pa Coffe | ome/scncat efter Ie | gg Gone ne eect ae repos| 034 aeeccmen manger
1 Part E 02-Nov-2009 over the counter
Checklist 02-Nov-2009 | over the counter
John Norden Pans 02-Nov-2009 | over the counter

 

 

 

 

[Portable L Long Service Service Leave (PLsL) levy (Applcabe fi for certain ain building and and construction tion work valued ove over $80,000 only)

 

 

 

10. The Portable Long Service Leave Levy (PLSL) is not applicable to this application if any of the following apply: ( ( Tick box it applicabe)

(CJ the application seeks a preliminary approval only;

([] the application is not for building and construction work under the Building and Construction Industry (Portable Long Service
Leave) Act 1991, section 3AA (e.g. the application is only for a change of use, or for the following types of work carried out solely for
farming purposes: land clearing, site preparation, earthworks, fences, fodder harvesting, clearing of encroaching vegetation, clearing of
regrowth, thinning vegetation or controlling weeds or pests);

[X all costs, that relate to the work both directly and indirectly, are less than $80,000, inclusive of GST; or

(C1 the work is being carried out under an owner-builder permit issued under the Queens/and Building Services Authority Act 1991 -
Complete and submit a QLeave Notification and Payment Form (no payment required if owner-builder permit number stated). The receipted form must be
Sighted by the assessment manager before a development permit can be given.

11.

EX] No - End of Part A

(1) Yes - Answer Q12 below

ls payment of a PLSL levy applicable to this application? (Refer to Q10 and the Advice below for more information)?

 

OFFICE USE ONLY (For use by the Assessment Manager / Private Certifier) (Optional)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

, Receiving officer's Reference
Fee ($) lyre Date received 16 “ (<4 name P5 Aras numbers 04 | (<€3
J
\ NOTIFICATION OF ENGAGEMENT OF PRIVATE CERTIFIER |
To: (Council, | have been engaged as the private certifier for the building work referred to in this application.
Date of Name BSA Certification number | Building classifications
engagement 3
QLEAVE NOTIFICATION AND PAYMENT (for completion by assessment manager or private certifier if applicable)
Date receipted
Description of the work QLeave Project Number |Amount paid ($)| Date paid form sighted by Name of offices who sighted the
manager
{
Privacy Statement

The information collected on Form 1 will be used by the Department of Infrastructure and Planning {DIP} in accordance with the processing and assessment of your Application.
Your personal details will not be disclosed for a purpose outside of the IDAS process, except where required by legislation {including the Freedom of Information Act 1992) or as
required by Parliament. This information may be stored in a DIP database. The information collected will be retained as required by the Public Records Act 2002.

 

Advice for completing Part A

 

General advice

 

. Part A of IDAS Development Application Form 1 must be completed and accompany all development applications. The applicant is responsible
for answering all questions fully and correctly, unless following a response there is a statement to go directly to another question. The
Assessment Manger may refuse to receive an application that is not properly made.

. The IDAS Assessment Checklist must also be completed for all development applications, other than those requiring assessment against the
Building Act 1975 only, i.e. those applications requiring the completion of Parts A and B only.