Revised DA Form 1

Clearing native vegetation

clearing nativ

| (7 Yes — this development application includes written confirmation from the chief executive of the Vegetation
| Management Act 1999 (s22A determination)
LI No
| Note: 1. Where a development application for operational work or material change of use requires 2 S22A determination and this is not included,

the compen ea is prohibited development.
vonmentiand/vegetation/applying tor further information on how to obtain a 822A determination.

 

Environmental offsets

 

ee ene environme ntal matter

| Dar TU nisribstediye tcl eh arieroranertal ott haat bal protded ®rst prescribed acavey nesatsed 6
| — having a significant residual impact on a prescribed environmental matter

| LI No

| Note: eae ea nacional ei aemeanen OMAR eee ene gov ay for further information on

| (1 Yes — the development application involves premises in the koala habitat area in the koala priority area
| (1 Yes — the development application involves premises in the koala habitat area outside the koala priority area
| CINo

| Note: if. koala habitat area determination has been obtained for this premises and is current over the iand, it should be provided as part of this
devaiopment application. See koala habitat area guidance matenals at wow des.gid gov au for further information

ound water throu

é. lake or sprin

 

CI Yes ~ Se ernie ws conadoted arvt ematted tee tevekeginart appieaen wed eckvwoaketen War 3
relevant authorisation or licence under the Water Act 2000 may be required prior to commencing development
| CINo
| Note: Contact the Department of Natural Resources, Mines and Energy al yww.darme. aid gov.au for further information.
| OA templates are available from hites /pianning.dsdmig.gid gov.au/. if the development application involves.
i? 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 Formt Template 2
Taking overland flow water. complete DA Form 1 Ternpiate 3.

 

   
 

| clyves— Pe OTArN Unease Chattcled ard ataehad et Ges aedarmere eppaceton

[No
| DA tempiates are avaiable trom bitps /olenning dsdmip.aid.gov.au/. For a development application involving waterway barrier works, complete
| DA Form 1 Template 4.

 

| (Yes - or maaccleled eeciete chiar anGrky = ciaeives w Wile iooticrarerd spphcalior if required under
| the Fisheries Act 1994
| CINo

| Note: Soe guidance materials st wwrw.dal aid gov.au for further information.

Page 9
DA Form 1 — Development application detaiis
Version 1.3 28 September 2020