DA Form

DA Form 1 - Development application details
Approved form (version 1.3 effective 28 September 2020) made under section 282 of the Planning Act 2016.


This form must be used to make a development application involving code assessment or impact assessment,
except when applying for development involving only building work.
For a development application involving building work only, use DA Form 2 - Building work details.
For a development application involving building work associated with any other type of assessable development
(i.e. material change of use, operational work or reconfiguring a lot), use this form (DA Form 1) and parts 4 to 6 of
DA Form 2 - Building work details.
Unless stated otherwise, all parts of this form must be completed in AjII and all required supporting information must
accompany the development application.
One or more additional pages may be attached as a schedule to tnis development application if there is insufficient
space on the form to include all the necessary information.

 This form and any other form relevant to the development application must be used to make a development
 application relating to strategic port land and Brisbane core port land under the Transport Infrastructure Act 1994,
 and airport land under the Airport Assets (Restructuring and Disposal) Act 2008. For the purpose of assessing a
 development application relating to strategic port land and Brisbane core port land, any reference to a planning
 scheme is taken to mean a land use plan for the strategic port land, Brisbane port land use plan for Brisbane core
 port land, or a land use plan for airport lanu.
Note: All terms used in this form have the meaning given under the Planning Act 2016, the Planning Regulation 2017, or the Development
      Assessment Rules (DA Rules).            ‘'                     ■



PART 1 - APPLICANT DETAILS

  Applicant name(s) (individual or company full name)                              David E Hughes & Jennifer A Crowcombe
  Contact name (only applicable for comparias)

  Postal address (P.O. Box or street address)                                      121 Tinbeerwah Rd                                10
  Suburb                                                                           Tinbeer.rah
  State                                                                            Old
  Postcode                                                                         4563    r                                j     FEB      F
  Country                                                                          Australia                                ArNoosaWcilA
                                                                                                                              . Noosa
  Contact number                                                                   0406 089 541        (Jennifer)             \ CTGounterZ/V/
  Email address (non-mandatory)                                                    [email protected]
  Mobile number (non-mandatory)                                                    As above
  Fax number (non-mandatory)
  Applicant’s reference number(s) (if applicable)

  2) Owner’s consent
 ---- ------------------------------------------------ :------- 7----- -- ''                       ------------- Ji------
  2 1) Is written consent of the owner required for this developmefi^application?^ •
  □ Yes - the written consent of the owner(s) is attached to this development application
  □ No - proceed to 3)                  y


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                                                                                   /Box:               R: PteS™                   Queensland
                                                                         I                                                        Government