Revised DA Form 1

 

( 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: [

 

 

 

 

    

(Yes — All easement locations, types and dimensions are included in plans submitted with this development

i application

PART 3 —- DEVELOPMENT DETAILS

 

Section 1 -— Aspects of development

  

8) What is the type of development? (ick only ane bax)
( Material change of use [J Reconfiguring a lot (25 Operational work C1 Building work
b) What is the approval type? jtick only one box)
Ky Development permit (C] Preliminary approval Crem aopl ft nes rton pos
¢) What is the level of assessment? 3 sf 2

Code assessment (7) impact assessment (gure pte rte
be eereae sad a, :

 

 

 

 

   

 

 

   

 

 

 

( Material change of use (J Reconfiguring a lot [operator wr Cuicng work

b) What is the approval type? itik only ane box)

(] Development permit (J Preliminary approval [Primary aprvel at ncues a vrstion approval
c) What is the tevel of assessment?

(1) Code assessment C1 impact assessment (requires public notication)

pa a ata
tots):

 

 

 

 

 

 

 

 

 

 

 

Page 3
DA Form 1 — Development application details
Version 1.3— 28 September 2020