Revised DA Form 1

 
   

( Yes ~ Schedule 12A Is applicable to the development application and the assessment benchmarks contained in
schedule 12A have been considered
CINo |

| Note: See guidance matenals at www. 2ianning dsdmin.2/G.gov.au for further information.

PART 8 — CHECKLIST AND APPLICANT DECLARATION

| have identified the assessment manager in question 15 and ail relevant referral
requirement(s) in question 17 Elves
Note: See the Planning Regulation 2017 for reterral requirements

if building work is associated with the proposed development, Parts 4 to 6 of DA Form 2 — (C1 Yes

Building work details have been completed and attached to this development application EANot applicable
Supporting information addressing any applicable assessment benchmarks is with the

development application

Note: This is a mandatory requirement and includes any relevant templates under question 23, @ planning report & Yes

 

 

Forms Guide: Piganing Ri

Relevant plans of the development are attached to this development application
Note: Relevant pians are required to be submitted for ail aspects of this development application. For further Byes
information, see DA Forms Guide. Relevant plans,

The portable long service leave levy for QLeave has been paid, or will be paid before a C1 Yes
development permit is issued (see 27) & Not applicable

C By making this development application, | declare that all information in this development application is true and

correct

(C] Where an email address is provided in Part 1 of this form, | 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 uniawful to intentionally provide false or misleading information.

 

 

 

 

 

| 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 contained 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 :

* fequired 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.

 

 

 

Page 14
DA Form 1 ~ Development appiication details
Version 1.3— 2B September 2020