202004666 - DA Form 1 - Development Application.pdf

PART 9 – FOR COMPLETION OF THE ASSESSMENT MANAGER – FOR OFFICE
USE ONLY

 Date received:                                   Reference number(s):

 Notification of engagement of alternative assessment manager
 Prescribed assessment manager                                   Pacific BCQ
 Name of chosen assessment manager                               DON GREHAN
 Date chosen assessment manager engaged                          20/11/2020
 Contact number of chosen assessment manager                     07 5412 1520
 Relevant licence number(s) of chosen assessment                 A739669
 manager

 QLeave notification and payment
 Note: For completion by assessment manager if applicable
 Description of the work                                         N/A
 QLeave project number                                           N/A
 Amount paid ($)                    N/A                          Date paid (dd/mm/yy)           N/A
 Date receipted form sighted by assessment manager               N/A
 Name of officer who sighted the form                            N/A




                                                                                                                          Page 12
                                                                                        DA Form 1 – Development application details
                                                                                                     Version 1.2— 7 February 2020


[OCR of page images]
PART 9 — FOR COMPLETION OF THE ASSESSMENT MANAGER — FOR OFFICE

USE ONLY

 

 

Date received: [sid Reference number(s): | |
Notification of engagement of alternative assessment manager

 

 

 

 

manager

Prescribed assessment manager Pacific BCQ
Name of chosen assessment manager DON GREHAN
Date chosen assessment manager engaged 20/11/2020
Contact number of chosen assessment manager 07 5412 1520
Relevant licence number(s) of chosen assessment A739669

 

QLeave notification and payment
Note: For completion by assessment manager if applicable

 

 

 

 

 

 

Description of the work N/A
QLeave project number N/A
Amount paid ($) [ N/A Date paid (dd/mm/yy) [N/A
Date receipted form sighted by assessment manager N/A
Name of officer who sighted the form N/A

 

 

Page 12
DA Form 1 — Development application details
Version 1.2— 7 February 2020