Application for permit to damage vegetation - OPW13/0572

Table K

Name of local government for the tidal area (if applicable)        Port authority for the tidal area (if applicable)




8.    Are there any existing easements on the premises? (e.g.for vehicular access, electricity, overland flow,
      water etc)



o     No    0 Yes-ensure the type, location and dimension of each easement is included in the plans submitted

9.    Does the proposal include new building work or operational work on the premises? (Including any
      services)

o     No    0 Yes-ensure the nature, location and dimension of proposed works are included in plans submitted

10.   Is the payment of a portable long service leave levy applicable to this application? (Refer to notes at the
      end of this form for more information.)


&6 No-go      to question 12      DYes

11.   Has the portable long service leave levy been paid? (Refer to notes at the end of this form for more
      information.)

o     No


o Yes--<:omplete Table L and submit with this application the yellow local government/private certifier’s copy of the
      receipted QLeave form

Table L

Amount paid                                                     Date paid        QLeave project number (6digit number

                                                                (dd/mm/yy)       starting with A, 8, E, L or P)




12.   Has the local government agreed to apply a superseded planning scheme to this application under
      section 96 of the Sustainable Planning Act 20091


D     No


D     Yes-please provide details below

Name of local government                        Date of written notice given   Reference number of written notice given
                                                by local government            by local government (if applicable)
                                                (dd/mm/yy)




                                                                                               IDAS form 1-Application details
                                                                                                      Version 3.0-1 July 2013