07/2605 - Preliminary Building Works Assessable Against the Planning Scheme [As Published] · 172007.2605

INTEGRATED PLANNING ACT 1997 Part N, Version 2.0, 3 September 2007

   

_Form 1 Development Application

Part N

_ontaminated land

4. Whatis the nature of the application and the nature of the contamination on the premises? (Tick applicable box/es)

 

 

Nature of the application Nature of the contamination
Material change ofuse |["] (i) All or part of the premises is on the Environmental Management Register
(_] Reconfiguring a lot Oi (i) All or part of the premises is on the Contaminated Land Register
@ Oo (iil) All or part of the premises is currently used for, or if there is no existing use, was last
used for -

(Ce) a notifiable activity

L](b) _ an industrial activity and the proposed use is for a child care centre,
educational, recreational or residential purpose (including a caretaker
residence on industrial land)

Oo (iv) {n an area for which an “area management advice’ has been given for natural
mineralisation or industrial activity and the proposed use is for a child care centre,
educational, recreational or residential purpose (including a caretaker residence on

industrial land)

   
   

gement advice’ has been given for unexploded

 

 

 

 

 

 

 

Mandatory information

 

*

ipanies this application.

 

2. Confirm the following mandatory informati

 

Confirmation of
e@ lodgement Methed of lodgement
(i) Plans showing where any notifiable activities, hazardous contaminant or potentially contaminated
“ : [_]Confirmed

activity has occurred on the premises

(ii) {f the application involves a material change of use from an industrial use to a more sensitive use (e.
g. child care, educational, recreational or residential purpose, including a caretaker residence on
industrial land), a detailed site history outlining previous potentially contaminated uses on the
premises

 

 

[_]Confirmed

 

 

 

 

 

[X]Not applicable

 

 

OFFICE USE ONLY

 

 

 

 

Date Received Reference Numbers