Development Application - Part 1 of 4 - IDAS Form 1 & 6

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Privacy-the information collected in this form 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 Right to Information Act 2009) or as required

by Parliament. This information may be stored in a departmental database. The information collected will be retained as
required by the Public Records Act 2002.



OFFICE USE ONLY

  Date received                                             Reference numbers



NOTIFICATION OF ENGAGEMENT OF A PRIVATE CERTIFIER

  To

             I                          I   (ouncil.I have been engaged as the pdvate ",tifi.,for the building work referred
                                            to in this application




                                                                                                                 Building
Date of engagement        Name                                          BSA Certification license number
                                                                                                                 c1assificationjs




QLEAVE NOTIFICATION AND PAYMENT (for completion by assessment manager or private certifier if applicable)
                                                                                        Date receipted

                                  QLeave Project          Amount paid                   form sighted by          Name of officer who
Description of the work                                                     Date paid
                                  Number                  ($)                           assessment               sighted the form
                                                                                        manager




  The Sustainable PlanningAct 2009(SPA)is administered by the Department of Infrastructure and Planning. This form and
  all other required application materials should be sent to your assessment manager and any referral agencies.




                                                                                         AI’/), ’{,1rio   fer"   <-IDAS form 1
                                                                                            Version 1.0 18 December 2009


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Privacy—the information collected in this form 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 Right to Information Act 2009) or as required
by Parliament. This information may be stored in a departmental database. The information collected will be retained as
required by the Public Records Act 2002.

 

OFFICE USE ONLY

 

Date received

 

 

Reference numbers

 

 

 

 

NOTIFICATION OF ENGAGEMENT OF A PRIVATE CERTIFIER

 

To

 

 

 

Council. | have been engaged as the private certifier for the building work referred
to in this application

 

Date of engagement

Name

BSA Certification license number

Building
classification/s

 

 

 

 

 

QLEAVE NOTIFICATION AND PAYMENT (for completion by assessment manager or private certifier if applicable)

 

Date receipted

ea QLeave Project Amount paid : form sighted by |Name of officer who
D f d
escription of the work Number ($) Date pai assessment sighted the form
manager

 

 

 

 

 

 

 

 

The Sustainable Planning Act 2009 (SPA) is administered by the Department of Infrastructure and Planning. This form and
all other required application materials should be sent to your assessment manager and any referral agencies.

—IDAS form 1

Version 1.0 18 December 2009