DA Form 1 - 6 -10 Diamond Street, Cooroy - 21.12.2018

    No
Note: Contact the Department of Environment and Heritage Protection at www.ehp.qld.gov.au for further information.

Referable dams
23.11) Does this development application involve a referable dam required to be failure impact assessed under
section 343 of the Water Supply (Safety and Reliability) Act 2008 (the Water Supply Act)?
   Yes – the ‘Notice Accepting a Failure Impact Assessment’ from the chief executive administering the Water Supply
Act is attached to this development application
   No
Note: See guidance materials at www.dews.qld.gov.au for further information.

Tidal work or development within a coastal management district
23.12) Does this development application involve tidal work or development in a coastal management district?
    Yes – the following is included with this development application:
         Evidence the proposal meets the code for assessable development that is prescribed tidal work (only required if
       application involves prescribed tidal work)
           A certificate of title
    No
Note: See guidance materials at www.ehp.qld.gov.au for further information.
Queensland and local heritage places
23.13) Does this development application propose development on or adjoining a place entered in the Queensland
heritage register or on a place entered in a local government’s Local Heritage Register?
    Yes – details of the heritage place are provided in the table below
    No
Note: See guidance materials at www.ehp.qld.gov.au for information requirements regarding development of Queensland heritage places.

Name of the heritage place:                                                        Place ID:
Brothels
23.14) Does this development application involve a material change of use for a brothel?
    Yes – this development application demonstrates how the proposal meets the code for a development application
for a brothel under Schedule 3 of the Prostitution Regulation 2014
    No
Decision under section 62 of the Transport Infrastructure Act 1994
23.15) Does this development application involve new or changed access to a state-controlled road?
    Yes - this application will be taken to be an application for a decision under section 62 of the Transport
Infrastructure Act 1994 (subject to the conditions in section 75 of the Transport Infrastructure Act 1994 being satisfied)
    No

PART 8 – CHECKLIST AND APPLICANT DECLARATION
24) Development application checklist
I have identified the assessment manager in question 15 and all relevant referral
requirement(s) in question 17                                                                                           Yes
Note: See the Planning Regulation 2017 for referral requirements
If building work is associated with the proposed development, Parts 4 to 6 of Form 2 –                                  Yes
Building work details have been completed and attached to this development application                                  Not applicable
Supporting information addressing any applicable assessment benchmarks is with
development application
Note: This is a mandatory requirement and includes any relevant templates under question 23, a planning report          Yes
and any technical reports required by the relevant categorising instruments (e.g. local government planning
schemes, State Planning Policy, State Development Assessment Provisions). For further information, see DA
Forms Guide: Planning Report Template.
Relevant plans of the development are attached to this development application                                          Yes
Note: Relevant plans are required to be submitted for all aspects of this development application. For further
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                                                                                                           DA Form 1 – Development Application details
                                                                                                                             Version 1.0—3 July 2017