DA Form

  Clearing native vegetation                   . *                  .
  23.3) Does this development application involve clearingjiative vegetation that requires written confirmation that
  the chief executive of the Vegetation Management Act* 1999 is satisfied the clearing is for a relevant purpose under
  section 22A of the Vegetation Management Act 1999?           *■ ,
  □ Yes - this development application includes written confirmation from the chief executive of the Vegetation
    Management Act 1999 (s22A determination)
  □ No
  Note: 1. Where a development application for operational work or material change of use requires a s22A determination and this is not included,
           the development application is prohibited development.
        2 See bttP.s;//www. qld. qov. au/environmeni/land/vegetauon/applyina for further information on how to obtain a s22A determination.

  Environmental offsets                                                             “
                                                   *                          ’w

  23.4) Is this development application taken to be a prescribed activity that may have a significant residual impact on
  a prescribed environmental matter under the ^nytro/j/ne/tta/ Offset Act 20142
  □ Yes I acknowledge that an environmental offset must be provided for any prescribed activity assessed as
    having a significant residual impact on a. prescribed environmental matter
    No                                                 \
| Note. The environmental offset section of the Queensl^r d Government's website can be accessed at www. qld. qov.au for further information on
  environmental offsets.                                     .      "     ■

  Koala habitat in SEQ Region                                                 ,a,       ..        •
 23.5) Does this development application involve a material change of use, reconfiguring a lot or operational work
 which is assessable development under Schedule ’10, Part 1 Cfbf-the Planning. Regulation 2017?
 S Yes - the development application involves premises in the koala habitat area in the koala priority area
 □ Yes - the development application involves premises in the koala habitat a ea outside the koala priority area
 {□No
  Note: If a koala habitat area determination has been obtained for this premises and is current over the land, it should be provided as part of this
j development application. See koala habitat area guidance materials at wwyv. des. Qld.qov. au for further information.


 Water resources                               ‘                               -                            'i
 23 6) Does this development application inyol/e takingomnterfering with underground water through an
 artesian or subartesidn bore, taking br4nterfering with water in a watercourse, lake or spring, or taking
 overland flow water under the Water Act ZOOOP ♦ ■> . '
 □ Yes - the relevant template is completed and attache 4 to this development application and I acknowledge that a
   relevant authorisation or licence under the Water Act 2ri00 may be required prior to commencing development
 □ No                                                     ■    “
 Note Contact the Department of Natural Resources, Mines and Energy at www. dnrme. qld.qov.c.j for further information.
 DA templates are available from https://planninq.dsdmip. qld.gov, au/ If           development application involves:
 •    Taking or interfering with underground water through an artesian or suba^esian borb: complete DA Form 1 Template 1
 »    Taking or interfering with water in a watercourse, lake or spring: complete DA Form 1 Template 2
 •    Taking overland flow water: complete DA Form 1 Template 3.
 Waterway barrier works         z                           :
 23.7) Does this application involve waterway barrier works?                                                1)
 O Yes - the relevant template is completed and attached to this development application
 0 No
 DA templates are available from https://plannmp.c!sdmip.gid acv.au/. Far a development application involving waterway barrier works, complete
 DA Form 1 Template 4.                              '       -

 Marine activities                                          *   ’       -i>                           ir.                                      "u
 23.8)*Does this development application' iflvojyeaquftculture, works within ^declared fish habitat area of
 removal, disturbance or destruction of marine |aJants>          M           r
 □ Yes - an associated resource allocation authority is attached to this development application, if required under
   the Fisheries Act 1994
•S No
 Note See guidance materials at www.daf.gld.qov.au for further information.                  >.




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