08/1928 - Preliminary Building Approval [As Published] · 172008.1928

INTEGRATED PLANNING ACT 1997 Part A, Verston 3.1,3 Mar,

Attachments and supporting information (Comprete Tabia 1- Use a separate row for euch type of attachment or inforuiation, inctieing information tegen ed uritar
this Part} Please ensure all documentation submitted with this form, including other Parts of Form 1, or owner's consent, atc, aro securely affached to this Part of he Form.

 

 

 

 

Description of attachment or information ‘ Method of deli
Table | Title (if appitcable) ethod of delivery lo
(29. Pat Gat Form owner Sconce A (ag. Ganeral Autorty, James Stree Trafic Report Date assessment manager
‘ CART & buroive, Wbre|f jie}
6
QOT

 

 

J

Portable Long Service Leave (PLSL) levy (Applicable for cerlate building and construction work vatued over $80,000 arly)

 

 

 

 

 

40. The Portable Long Service Leave Levy (PLSL) is not applicable to this application if any of the following apply: ; +“ te.
(J the application seeks a preliminary approval only;

 

(1 the application is not for building and construction work under the Building and Construction industry (Portable Long Service Leave)
Act 1991, section 3AA (e.g. the application Is only for a changa of use, or for tha following (ypes of work carrled out solely for farming purposes:
land clearing, site preparation, earthworks, fences, fodder harvesting, clearing of encroaching vegetation, clearing of regrowth, thinning vegetation or

ntrotling weeds or pests),

all costs, that relate to the work both directly and indirectly, are less than $80,000, Inclusive of GST; or

ing carried out under an owner-bullder permit issued under the Queensland Building Services Authority Act 1991 -
wnita OLeave Notticaion arf Payniait For foo payriontrequarad ifowney-buikiar purrtat number stalew) Phe recepied form may! be satis! Ly hear

 

  

42, Hag the PLSL levy been paid?’ ° ne a
No ~ (NOTE: An application can be lodged prior to payment of the applicable PLSL levy. However, the fevy must be pald and the raceipted form sighted by the

Assessment Manager before a development parmit may be given for this application. To pay the fevy you will need fo complete and submit a Notification
and Payment Form to QLeave.)

ol Yes - Conpicte Table & au subrvt, wilh tha apphcation, the ‘yellow (Local Guvernment s (Cannes) ¢ Private Comics s) copy of tua rece pint Coeaeg Fever,

QLeave Project Number
Table L Amount paid Date pald (6digts, starting with A, BE, Lor P)

 

 

1,

 

 

 

 

 

 

 

OFFICE USE ONLY (For use by the Assessment Manager / Private Certifier) (Optional)

 

Fee (8) Date received ° Roe Reference

NOTIFICATION OF ENGAGEMENT OF PRIVATE CERTIFIER

To: Council, | have been engaged as the private cerlifier for the building work referred to In this application,
| Date of engagement Name | BSA Certification license number | Building ciassification/s
i | |
« QLEAVE NOTIFICATION AND PAYMENT (for completion by assessment manager or private certifier if applicable)
Amount pald Date receipted form ~~ 7

(8) Date paid sighted by Nama of officer who sighted the form
assessment manager

 

 

 

 

 

 

 

 

 

 

 

 

 

Description of the work QLeave Project Number

 

 

 

 

 

 

 

 

 

Privacy Statement %

The information collected on Form twill be used by the Department of fnfrastructura and Planning (DIP) in accordance with the processing and assessment of your Application.
Your personal details will not be disclosed for a purpose outside of fhe {DAS process, except wharo required by fegistation (including the Freedom of information Act 1992) or
as required by Parliament. This information may bo stored in a DIP database, The information collected will be retained as required by the Publle Records Act 2002.

 

Page 3