DA Form 2

h) Relevant plans
Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms Guide:
      Relevant plans.

    Relevant plans of the proposed works are attached to the development application


17) What is the monetary value of the proposed building work?

$547,407


18) Has Queensland Home Warranty Scheme Insurance been paid?

    Yes – provide details below

    No

Amount paid                               Date paid (dd/mm/yy)                             Reference number

$


PART 6 – CHECKLIST AND APPLICANT DECLARATION
19) Development application checklist
The relevant parts of Form 2 – Building work details have been completed                                         Yes
This development application includes a material change of use, reconfiguring a lot or
                                                                                                                 Yes
operational work and is accompanied by a completed Form 1 – Development
                                                                                                                 Not applicable
application details
Relevant plans of the development are attached to this development application
Note: Relevant plans are required to be submitted for all aspects of this development application. For further   Yes
information, see DA Forms Guide: Relevant plans.

The portable long service leave levy for QLeave has been paid, or will be paid before                            Yes
a development permit is issued (see 9)                                                                           Not applicable


20) Applicant declaration
    By making this development application, I declare that all information in this development application is true and
    correct
    Where an email address is provided in Part 1 of this form, I consent to receive future electronic communications
    from the assessment manager and any referral agency for the development application where written
    information is required or permitted pursuant to sections 11 and 12 of the Electronic Transactions Act 2001
Note: It is unlawful to intentionally provide false or misleading information.
Privacy – Personal information collected in this form will be used by the assessment manager and/or chosen
assessment manager, any referral agency and/or building certifier (including any professional advisers which may
be engaged by those entities) while processing, assessing and deciding the development application.
All information relating to this development application may be available for inspection and purchase, and/or
published on the assessment manager’s and/or referral agency’s website.

Personal information will not be disclosed for a purpose unrelated to the Planning Act 2016, Planning Regulation
2017 and the DA Rules except where:
 such disclosure is in accordance with the provisions about public access to documents contained in the Planning
   Act 2016 and the Planning Regulation 2017, and the access rules made under the Planning Act 2016 and
   Planning Regulation 2017; or
 required by other legislation (including the Right to Information Act 2009); or
 otherwise required by law.
This information may be stored in relevant databases. The information collected will be retained as required by the
Public Records Act 2002.