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2303-33746 DA Form1 Application details_3
DA Form 1 – Development application details
Approved form (version 1.3 effective 28 September 2020) made under section 282 of the Planning Act 2016.
This form mustbe used to make a development application involving code assessment or impact assessment,
except when applying for development involving only building work.
For a development application involving building work only, use DA Form 2 – Building work details.
For a development application involving building work associated with any other type of assessable
development (i.e. material change of use, operational work or reconfiguring a lot ), use this form (DA Form 1)
and parts 4 to 6 of DAForm 2 – Building work details.
Unless stated otherwise, all parts of this form must be completed in full and all required supporting information
must accompany the development application.
One or more additional pages may be attached as a schedule to this development application if there is
insufficient space on the form to include all the necessary information.
This form and any other form relevant to the development application must be used to make a development application
relating to strategic port land and Brisbane core port land under the Transport Infrastructure Act 1994, and airport land
under the Airport Assets (Restructuring and Disposal) Act 2008. For the purpose of assessing a development
application relating to strategic port land and Brisbane core port land, any reference to a planning scheme is taken to
mean a land use plan for the strategic port land, Brisbane port land use plan for Brisbane core port land, or a land use
plan for airport land.
Note: All terms used within this form have the meaning given under the Planning Act 2016, thePlanning Regulation 2017, or the Development Assessment
Rules (DA Rules).
PART 1 – APPLICANT DETAILS
1) Applicant details
Applicant name(s) (individual or company full name) Tim Storrer
Contact name (only applicable for companies)
Postal address (P.O. Box or street address) PO Box 963
Suburb / State / Postcode Cooroy QLD 4563
Country Australia
Contact number 0414681676
Email address (non-mandatory) [email protected]
Mobile number (non-mandatory)
Fax number (non-mandatory)
Applicant’s reference number(s) (if applicable)
2) Owner’sconsent
2.1) Is written consent of the owner required for this development application?
Yes – the written consent of the owner(s) is attached to this development application
No – proceed to question 3)
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PART 2 – LOCATION DETAILS
3) Location of the premises (complete 3.1) or 3.2), and 3.3) as applicable)
Note: Provide details below and attach a site plan for any or all premises part of the development application. For further information, see DA Forms Guide:
Relevant plans.
3.1) Street address andlot on plan
Street address AND lot on plan (all lots must be listed), or
Street address AND lot on plan for an adjoining or adjacent property of the premises (appropriate for development in water
but adjoining or adjacent to land e.g. jetty, pontoon. All lots must be listed).
Unit No. Street Street Name Street Type
No.
3 Mermaid
Suburb Postcode Lot No. Plan type and number (e.g.
a)
RP,SP)
Noosaville 38 RP839232
Local Government
Noosa Shire
Area(s)
3.2) Coordinates of premises (appropriate for development in remote areas, over part of a lot or in water not adjoining or adjacent to land e.g.
channel dredging in Moreton Bay)
Note: Place each set of coordinates in a separate row. Only one of the below options is required for this part.
Coordinates of premises by longitude and latitude or by easting and northing
Easting Northing Latitude Longitude Zone Ref. Datum Local Government Area (if
(s) (s) applicable)
3.3) Additional premises
Additional premises are relevant to this development application and the details of these premises have been attached
in a schedule to this development application
Not required
4) Identify any of the following that apply to the premises and provide any relevant details
In or adjacent to a water body or watercourse or above an aquifer
Name of water body, watercourse or aquifer: Noosa Waters Estate
On strategic port land under the Transport Infrastructure Act 1994
Lot on plan description of strategic port land:
Name of port authority for the lot:
In a tidal area
Name of local government for the tidal area (if
applicable):
Name of port authority for tidal area (if applicable):
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On airport land under the Airport Assets (Restructuring and Disposal) Act 2008
Name of airport:
Listed on the Environmental Management Register (EMR) under the Environmental Protection Act 1994
EMR site identification:
Listed on the Contaminated Land Register (CLR) under the Environmental Protection Act 1994
CLR site identification:
5) Are there any easements over the premises?
Note: Easement uses vary throughout Queensland and are to be identified correctly and accurately. For further information on easements and how they
may affect the proposed development, see DA Forms Guide.
Yes – All easement locations, types and dimensions are included in plans submitted with this development
application
No
PART 3 – DEVELOPMENT DETAILS
Section 1 – Aspects of development
6.1) Provide details about the first development aspect
a) What is the type of the development? b) What is the approval type?
(Please tick only one box) (Please tick only one box)
Material change of use Development permit
Reconfiguring a lot Preliminary approval
Operational work Preliminary approval that includes a variation approval
Building work
c) What is the level of assessment?
Code assessment
Impact assessment
6.2) Provide details about the second development aspect
a) What is the type of the development? b) What is the approval type?
(Please tick only one box) (Please tick only one box)
Material change of use Development permit
Reconfiguring a lot Preliminary approval
Operational work Preliminary approval that includes a variation approval
Building work
c) What is the level of assessment?
Code assessment
Impact assessment
Provide a brief description of the proposal (e.g. 6 unit apartment building defined as multi-unit dwelling, reconfiguration of 1 lot into 3 lots):
Operational Work which is a private jetty in the waterway of Noosa Waters Estate; and a Material Change of Use for
Infrastructure which is a Landing in a Low-Density Residential zone.
Relevant plans
Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms Guide: Relevant
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plans.
Relevant plans of the proposed development are attached to the development application
Additional aspects of development
Additional aspects of development are relevant to this development application and the details for these aspects that
would be required under Part 3 Section 1 of this form have been attached to this development application
Not required
Section 2 – Further development details
7) Does the proposed development application involve any of the following?
Material change of use Yes – complete division 1 if assessable against a local planning instrument
Reconfiguring a lot Yes – complete division 2
Operational work Yes – complete division 3
Building work Yes – complete DA Form 2 – Building work details
Division 1 – Material change of use
Note: This division is only required to be completed if any part of the development application involves a material change of use assessable against a local
planning instrument.
8.1) Describe the proposed material change of use
Provide a general description Provide the planning scheme Number of dwelling Gross floor area
of the proposed use definition (include each units (if applicable) (m2) (if
definition in a new row) applicable)
Private domestic jetty Landing
8.2) Does the proposed use involve the use of existing buildings on the premises?
Yes
No
Division 2 – Reconfiguring a lot
Note: This division is only required to be completed if any part of the development application involves reconfiguring a lot.
9.1) What is the total number of existing lots making up the premises?
9.2) What is the nature of the lot reconfiguration? (tick all applicable boxes)
Subdivision (complete10) Dividing land into parts by agreement (complete 11)
Boundary realignment (complete 12) Creating or changing an easement giving access to a lot
from a constructed road (complete 13)
10) Subdivision
10.1) For this development, how manylots are being created and what is the intended use of those lots:
Intended use of Residential Commercial Industrial Other, please specify:
lots created
Number of lots
created
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10.2) Will the subdivision be staged?
Yes – provide additional details below
No
How many stages will the works
include?
What stage(s) will this development
application apply to?
11) Dividing land into parts by agreement – how many parts are being created and what is the intended use of the parts?
Intended use Residential Commercial Industrial Other, please specify:
of parts
created
Number of
parts created
12) Boundary realignment
12.1) What are the current and proposed areas for each lot comprising the premises?
Current Lot Proposed Lot
Lot on plan description Area (m2) Lot on plan description Area (m2)
12.2) What is the reason for the boundary realignment?
13) What are the dimensions and nature of any existing easements being changed and/or any proposed easement? (attach
schedule if there are more than two easements)
Existing or proposed? Width (m) Length (m) Purpose of the Identify the land/lot(s)
easement? (e.g benefitted by the
pedestrian access) easement
Division 3 – Operational work
Note: This division is only required to be completed if any part of the development application involves operational work.
14.1) What is the nature of the operational work?
Road work Stormwater Water infrastructure
Drainage work Earthworks Sewage infrastructure
Landscaping Signage Clearing vegetation
Other – please specify: Waterway works (jetty)
14.2) Is the operational work necessary to facilitate the creation of new lots (e.g. subdivision)?
Yes – specify number of new lots:
No
14.3) What is the monetary value of the proposed operational work?(include GST, materials and labour)
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$55000.00
PART 4 – ASSESSMENT MANAGER DETAILS
15) Identify the assessment manager(s) who will be assessing this development application
Noosa Shire Council
16) Has the Local Government agreed to apply a superseded planning scheme for this development application?
Yes – a copy of the decision notice is attached to this development application
The local government is taken to have agreed to the superseded planning scheme request – relevant documents
attached
No
PART 5 – REFERRAL DETAILS
17) Does this development application include any aspects that have any referral requirements?
Note: A development application will require referral if prescribed by the Planning Regulation 2017.
No, there are no referral requirements relevant to any development aspects identified in this development
application – proceed to Part 6.
Matters requiring referral to the chief executive of the Planning Regulation 2017:
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Clearing native vegetation
Contaminated land (unexploded ordnance)
Environmentally relevant activities (ERA) (only if ERA has not been devolved to a local government)
Fisheries – aquaculture
Fisheries – declared fish habitat area
Fisheries – marine plants
Fisheries – waterway barrier works
Hazardous chemical facilities
Heritage places - Queensland heritage place (on or near a Queensland heritage place)
Infrastructure-related referrals – designated premises
Infrastructure-related referrals – state transport infrastructure
Infrastructure-related referrals – State transport corridors and future State transport corridors
Infrastructure-related referrals – State-controlled transport tunnels and future state-controlled transport tunnels
Infrastructure-related referrals –near a state-controlled road intersection
Koala Habitat area in SEQ Region – interfering with koala habitat in koala habitat areas outside koala priority
areas
Koala habitat area in SEQ Region – key resource areas
Ports - Brisbane core port land - near a State transport corridor or future State transport corridor
Ports - Brisbane core port land – environmentally relevant activity(ERA)
Ports - Brisbane core port land – tidal works or work in a coastal management district
Ports - Brisbane core port land – hazardous chemical facility
Ports - Brisbane core port land – taking or interfering with water
Ports - Brisbane core port land – referable dams
Ports - Brisbane core port land – fisheries
Ports - Land within Port of Brisbane’s port limits (below high-water mark)
SEQ development area
SEQ regional landscape and rural production area or SEQ rural living area – tourist activity or sport and
recreation activity
SEQ regional landscape and rural production area or SEQ rural living area – community activity
SEQ regional landscape and rural production area or SEQ rural living area – indoor recreation
SEQ regional landscape and rural production area or SEQ rural living area – urban activity
SEQ regional landscape and rural production area or SEQ rural living area – 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
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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 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 individual
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:
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 (below 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:
Tidalworks, 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 6 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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PART 6 – INFORMATION REQUEST
19) Information request under Part 3 of the DA Rules
I agree to receive an information request if determined necessary for this development application
I do not agree to accept an information request for this development application
Note: By not agreeing to accept an information request I, the applicant, acknowledge:
that this development application will be assessed and decided based on the information provided when making this development application
and the assessment manager and any referral agencies relevant to the development application are not obligated under the DA Rules to
accept any additional information provided by the applicant for the development application unless agreed to by the relevant parties
Part 3 of the DA Rules will still apply if the application is an application listed under section 11.3 of the DA Rules.
Further advice about information requests is contained in the DA Forms Guide.
PART 7 – FURTHER DETAILS
20) Are there any associated development applications or current approvals (e.g. a preliminary approval)?
Yes – please provide details below or include details in a schedule to this development application
No
List of Reference number Date Assessment manager
approval/development
application references
21) Has the portable long service leave levy been paid? (only applicable to development applications involving building work or operational
work)
Yes – a copy of the receipted QLeave form is attached to this development application
No – I, the applicant will provide evidence that the portable long service leave levy has been paid before the
assessment manager decides the development application. I acknowledge that the assessment manager may give a
development approval only if I provide evidence that the portable long service leave levy has been paid.
Not applicable (e.g. building and construction work is less than $150,000 excluding GST)
Amount paid Date paid (dd/mm/yy) QLeave levy number (A, B or E)
$
22) Is this development application is in response to a show cause or required as a result of an enforcement notice?
Yes, show cause or enforcement notice is attached.
No
23) Further legislative requirements
23.1) Environmentally relevant activities
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This development application is also taken to be an application for an environmental authority for an
Environmentally Relevant Activity (ERA) under section 115 of the Environmental Protection Act 1994. The
required attachment (form ESR/2015/1791) for an application for an environmental authority accompanies this
development application.
Note: Application for an environmental authority can be found by searching “ESR/2015/1791” at www.qld.gov.au. An ERA requires an
environmental authority to operate. See www.business.qld.gov.au for further information.
Multiple ERAs are applicable to this development application and the details have been attached in a schedule to
this development application.
Proposed ERA number: Proposed ERA threshold:
Proposed ERA name:
23.2) Hazardous chemical facilities
This development application is for a hazardous chemical facility. Form 69: Notification of a facility exceeding
10% of schedule 15 threshold is attached to this development application.
Note: See www.business.qld.gov.au for further information about hazardous chemical notifications.
23.3) Clearing native vegetation
This application involves clearing native vegetationthat requires written confirmation that the chief executive of the
Vegetation Management Act 1999 is satisfied the clearing is for a relevant purppose under section 22A of the
Vegetation Management Act 1999 and includes written confirmation from the chief executive of the Vegetation
Management Act 1999 (s22A determination).
Note: Where a development application for operational work or material change of use requires a s22A determination and this is not included,
the development application is prohibited development. See www.qld.gov.au/environment/land/vegetation/applying for further information on how
to obtain a s22A determination.
23.4) Environmental offsets
This development application is taken to be a prescribed activity that may have a significant residual impact on a
prescribed environmental matter under the Environmental Offsets Act 2014. I acknowledge that an environmental
offset must be provided for any prescribed activity assessed as having a significant residual impact on a prescribed
environmental matter.
Note: The environmental offset section of the Queensland Government’s website can be accessed at www.qld.gov.au for further information on
environmental offsets.
23.5) Koala habitat in SEQ Region
This development application is for development involving interfering with koala habitat area.
development involving interfering with koala habitat area in the koala priority area
development involves premises in the koala habitat area outside the koala priority area
Note: If a koala habitat area determination has been obtained for this premises and is current over the land, it should be provided as part of this
development application. See koala habitat area guidance materials at www.des.qld.gov.au for further information.
23.6) Water resources
This development application involves taking or interfering with underground water through an artesian or
subartesian bore, taking or interfering with water in a watercourse, lake or spring, or taking overland flow
water under the Water Act 2000. The relevant template is completed and attached to this development application
and I acknowledge that a relevant authorisation or licence under the Water Act 2000may be required prior to
commencing development.
Note: Contact the Department of Natural Resources, Mines and Energy at www.dnrme.qld.gov.au for further information.
DA templates are available from planning.dsdmip.qld.gov.au. If the development application involves:
Taking or interfering with underground water through an artesian or subartesian bore: complete DA Form 1 Template 1
Taking or interfering with water in a watercourse, lake or spring: complete DA Form1 Template 2
Taking overland flow water: complete DA Form 1 Template 3.
23.7) Waterway barrier works
This development application involves waterway barrier works. The relevant template is completed and attached
to this development application.
Note: DA templates are available from planning.dsdmip.qld.gov.au. For a development application involving waterway barrier works, complete
DA Form 1 Template 4.
23.8) Marine activities
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This development application involves aquaculture, works within a declared fish habitat area or removal,
disturbance or destruction of marine plants and, if required.An associated resource allocation authority is
attached to this development application, if required under the Fisheries Act 1994.
Note: See guidance materials at www.daf.qld.gov.au for further information.
23.9) Quarry materials from a watercourse or lake
This development application involves the removal of quarry materials from a watercourse or lake under the
Water Act 2000.I acknowledge that a quarry material allocation notice must be obtained prior to commencing
development.
Note: Contact the Department of Natural Resources, Mines and Energy at www.dnrme.qld.gov.auand www.business.qld.gov.aufor further
information.
23.10) Quarry materials from land under tidal waters
This development application involves the removal of quarry materials from land under tidal water under the
Coastal Protection and Management Act 1995.I acknowledge that a quarry material allocation notice must be
obtained prior to commencing development.
Note: Contact the Department of Environment and Science at www.des.qld.gov.au for further information.
23.11) Referable dams
This development application involves a referable dam required to be failure impact assessed under section 343 of
the Water Supply (Safety and Reliability) Act 2008 (the Water Supply Act). The ‘Notice Accepting a Failure Impact
Assessment’ from the chief executive administering the Water Supply Act is attached to this development
application.
Note: See guidance materials at www.dnrme.qld.gov.au for further information.
23.12) Tidal work or development within a coastal management district
This development application involves tidal work or development in a coastal management district and if
required, the following is included with this development application:
Evidence the proposal meets the code for assessable development that is prescribed tidal work (only required if
application involves prescribed tidal work)
A certificate of title.
Note: See guidance materials at www.ehp.qld.gov.au for further information.
23.13) Queensland and local heritage places
This development application proposes development on or adjoining a place entered in the Queensland heritage
register or on a place entered in a local government’s Local Heritage Register. Details of the heritage place are
provided in the table below.
Note: See guidance materials at www.des.qld.gov.au for information requirements regarding development of Queensland heritage place.
Name of heritage place: Place ID:
23.14) Brothels
This development application involves a material change of use for a brothel and demonstrates how the proposal
meets the code for development applications for brothels under Schedule 3 of the Prostitution Regulation 2014.
23.15) Decision under section 62 of the Transport Infrastructure Act 1994
This development application involves new or changed access to a state-controlled road, and will be taken to be an
application for a decision under section 62 of the Transport Infrastructure Act 1994(subject to the conditions in
section 75 of the Transport Infrastructure Act 1994 being satisfied).
23.16) Walkable neighbourhoods assessment benchmarks under Schedule 12A of the Planning Regulation 2017
This development involves reconfiguring a lot into 2 or more lots in certain residential zones (except rural residential
zones), where at least one road is created or extended. Schedule 12A is applicable to the development application
and the assessment benchmarks contained in schedule 12A have been considered
PART 8 – CHECKLIST AND APPLICANT DECLARATION
24) Development application checklist
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I have identified the assessment manager in question 15 and all Yes
relevant referral requirement(s) in question 17
Note: See the Planning Regulation 2017 for referral requirements
If building work is associated with the proposed development, Parts Yes
4 to 6 of DA Form 2 – Building Work details have been completed
and attached to this development application Not applicable
Supporting information addressing any applicable assessment Yes
benchmarks is with the development application
Note: This is mandatory and includes any relevant templates under question 23, a
planning report and any technical reports required by the relevant categorising
instruments (e.g. local government planning schemes, State Planning Policy, State
Development Assessment Provisions). For further information, see DA Forms guide:
Planning Report Template.
Relevant plans of the development are attached to this Yes
development application
Note: Relevant plans are required to be submitted for all aspects of this
development application. For further information, see DA Forms Guide: Relevant
Plans.
The portable long service leave levy for Qleave has been paid, or will Yes
be paid before a development permit is issued (see 21)
Not applicable
25) Applicant declaration
By making this development application, I declare that all information in this development application is true and
correct.
Where an email address is provided in Part 1 of this form, I consent to receive future electronic communications
from the assessment manager and any referral agency for the development application where written information is
required or permitted pursuant to sections 11 and 12 of the Electronic Transactions Act 2001.
Note: It is unlawful to intentionally provide false or misleading information.
Privacy—Personal information collected in this form will be used by the assessment manager and/or chosen assessment
manager, any relevant referral agency and/or building certifier (including any professional advisers which may be engaged
by those entities) while processing, assessing and deciding the development application.
All information relating to this development application may be available for inspection and purchase, and/or published on
the assessment manager’s and/or referral agency’s website.
Personal information will not be disclosed for a purpose unrelated to the Planning Act 2016, Planning Regulation 2017 and
the DA Rules except where:
such disclosure is in accordance with the provisions about public access to documents in the Planning Act 2016 and the
Planning Regulation 2017, and the access rules made under the Planning Act 2016 and Planning Regulation 2017; or
required by other legislation (including the Right to Information Act 2009); or
otherwise required by law.
This information may be stored in relevant databases. The information collected will be retained as required by the Public
Records Act 2002.
PART 9 – FOR COMPLETION OF THE ASSESSMENT MANAGER - FOR OFFICE
USE ONLY
Date received: Reference number(s):
Notification of engagement of alternative assessment manager
Prescribed assessment manager
Name of chosen assessment manager
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Date chosen assessment manager engaged
Contact number of chosen assessment manager
Relevant licence number(s) of chosen
assessment manager
Qleave notification and payment
Note: For completion by assessment manager if applicable
Description of the work
Qleave project number
Amount paid ($)
Date paid
Date receipted form sighted by assessment manager
Name of officer who sighted the form
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