07/0967 - MCU - Detached House [As Published] · 132007.967

INTEGRATED PLANNING ACT 1997 Part B, Version 2.0, 4 October 2004
Residential work cont 7. Fora proposal involving dweiling units, indicate each of the following (if appticable)

a) Number of existing dwelling units |
b) Number of dwelling units to be demolished fo
c) Number of new / additional self-contained dwelling units [id

BSA insurance is not required where the 8. What is the Building Services Authority (BSA) Insurance receipt number (if applicable)

 

 

 

 

 

 

 

 

 

builder is an owner-builder. ]
Builder's details (if known} 9. Name (in ful to be advised
Kf more than one builder, attach details e.g. C t i
builder X for the house and builder Y for the ontact details
pool. BSA Licence number
If owner-builder, state owner-builder number [.

 

 

 

10. Is the project “owner — builder”?

&INO

(J YES - provide “owner-builder’ number below

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Owner's details 11. [Name ¢in ftp Trust Clout pty Itd
@ sentation or Shae dene las ta Contact details | Paul Clout (07) 5440 5388

 

buildings or class 10 buildings or structures.

The nominated owner will receive a copy of
the decision notice and approved plans.

 

 

 

Release of owner's details 12. Does the owner agree to the release of their name & the land address for marketing purposes?
&J NO OYEs

Portable Long Service Leave levy (if | 13. 1s payment of a Portable Long Service Leaye (PLSL) levy applicable to the proposal?

spptcabie) YES

  
  
  

 

Prior to issuing a development permit for the
works, the assessment manager is required
by law to “sight” an approved form, issued by
QLeave, which signifies that the PLSL levy
has been paid.

 

 

 

 

PLEASE NOTE: This application cannot be accepted urk

time of lodgement, fails to provide alt applicable inff fequired by Part A and any other relevant part of Form 1,

 

 

OFFICE USE ONLY (applicable to assessment manager or private certifier) __ wee
e@ |_DATE RECEIVED T __| REFERENCE NUMBER/S

eh — —- ee ee ee

 

 

[() What is the building classification?

(ii) Is a PLSL levy applicable in this instance? mie) (J YES - complete afi)

 

manager / private certifier at the time of lodgement of this application?

(No (YES - provide receipt details below

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(iii) Has the approved form (issued by QLeave and which signifies that the PLSL levy has been paid) been sighted by the assessment
'
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