OPW14/0282 - Application for operational works - 10 The Anchorage, Noosaville

                       Question 12
                       .The portable long service leave levy need not be paid when the application is made, but the
                       Building and Construction Industry (Portable Long Service Leave) Act 1991 requires the levy
                       to be paid before a development permit is issued .
                       • Building and construction industry notification and payment forms are available from any
                       Queensland post office or agency, on request from QLeave, or can be completed on the
                       QLeave website at www.qleave.qld.gov.au. For further information contact QLeave on 1800
                       803481 or visit www.qleave.qld.gov.au.


                       Privacy-The     information collected in this fonm will be used by the Department of State
                       Development, Infrastructure and Planning (DSDIP), assessment manager, referral agency
                       andlor building certifier in accordance with the processing and assessment of your
                       application. Your personal details should not be disclosed for a purpose outside of the IDAS
                       process or the provisions about public access to planning and development information in the
                       Sustainable Planning Act 2009, except where required by legislation (including the Right to
                       Information Act 2009) or as required by Parliament. This information may be stored in relevant
                       databases. The information collected will be retained as required by the Public Records Act
                       2002.


                       OFFICE USE ONLY

                       Date received    1                                 IReference
                                            _                             'lUmbers

                       NOTIFICATION             OF ENGAGEMENT           OF A PRIVATE CERTIFIER

                       To                                                 iCouncil. I have been engaged as the private certifier
                             ____________                                 ~or the building work referred to in this application

                       Date of                                                         BSA Certification          Building
                                                 Name
                       enQaQement                                                      icense number               lassificationls




                       QLEAVE NOTIFICATION AND PAYMENT (For completion                          by assessment      manager or
                       private certifier if applicable.)

                                                                                                   Date
                                                                                                   receipted
                                                                                                                   Name of officer
                                                        QLeave project '\mount paid                 orm sighted
                       Description of the work                                           Date paid                 who sighted
                                                        number          $)                         by
                                                                                                                   he form
                                                                                                     ssessment
                                                                                                   manaaer




                       The Sustainable Planning Act 2009 is administered by the Department of State Development,
                       Infrastructure and Planning. This form and all other required application materials should be
                       sent to your assessment manager and any referral agency.




Department of State Development,       Infrastructure    and Planning
PO Box 15009 City East Old 4002
tol13 OGOV (13 74 68)
jnfo@dsdjn   qld gOY au
                                                                                                    IDAS form I-Application details
www.dsdip.qld.gov.au                                                                                       Vefsion 4.1-4 July 2014