2303-33746 DA Form1 Application details_3

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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                                                                                                 DA Form 1 – Development application details
                                                                                                           Version 1.3—28 September 2020