07/0261 - Op Works - Transport Type 5 - Domestic Marine (Jetty) [As Published] · 142007.261

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INTEGRATED PLANNING ACT 1997

Land owner’s consent (if applicable)

Section 3.2.1(3) of the IPA prescribes that an
application must contain, of be supported by, the
written consent of the land owner!s, if the application
invonves:

@ a material change of use,

(i) reconfiguration of a lot;

{work on land below high-water mark & not within a
canal as defined under the Coastal Protection and
Management Act 1995,0r

(iv) work on sail corridor land defined under the
Transport infrastructure Act 1994.

Section 3.8.1(2)(2) of the IPA provides that

landowner's consent is net requked for a mobile or

temporary ERA .

For more information refer to Guide 4.

20.

 

Part A, Version 2.4, 29 May 2006
Land owner's consent to the making of this application:

 

 

   

Name Signature Date
OR WI Wiatince DO. (9-02-07
ID, WAuace Ba Wece }2-0207

 

 

 

 

 

 

 

 

Resource entitlement (if applicable) 21.

Section 3.2.1(5) of the IPA requires evidence of
resource entitlement be given for applications that
involve a prescribed State resource,

Section 3.2. 1(10){a}{l) of the IPA prescribes that an
application cannat be taken to be properly made
without evidence of the resource entitement.
Advice for completing Q21 & 22

Refer to schedute 10 of the /niegrated Pisnning
Regulation 1996 that prescribes ihe nature of evidence
required by the State in support of the lodging of this
development application.

Advigg for complet

The information in (i) - {v) is mandatory if evidence is
required under O22 (ii) or (iil) above.

The official stamp of the Department of Natural
Resources, Mines and Water is mandatory where the
application involves any water or riverine quarry
material under the Water Act 2000.

Section 3.2.1(5A) allows the resource manager to limit
the time the evidence may be used. Q23 (vi) must be
completed if the evidence is time fmited.

 

23.

Does this application involve a State resource prescribed under a regulation (other than involving
quarp/ material on State coastal fand under the Coastal Protection and Management Act 1995)?
NO - go to Q24 (YES - goto 922

. This application is accompanied by evidence: (tick applicable box)

(71 (i) of the allocation of, or entitlement to, the resource - attach evidence and go to Q23(vi)

C1 (ii) the chief executive of the department administering the resource is satisfied the
development is consistent with an allocation of, or entitlement to, the resource - go
10. Q23

C1 fill) the chief executive of the department administering the resource is satisfied the

development application may proceed in the absence of an allocation of, or
entitlement to, the resource - go to Q23

 

Evidence of the resource entitlement:

(i) Resource entitlement / authority details (vii) Official stamp of the department
administering the resource (if
applicable)

{ii) Name of “— officer

(ii) Position of “a officer

(iv) Signature of delegated officer

 

 

(v) Date

(vi) pe date of evidence fete

 

 

 

 

Assessment triggers

This checklist does not apply if the application requires
the competion of Parts A and B of the Form onfy, It
musi be completed for afl other applications.

24.

Is the IDAS Assessment Checklist completed and attached to this application?
(J Yes

oO NO - the assessment manager may refuse to accept this application on the
grounds that the application has not been properly made

 

 

 

Plans / drawings / reports

An application should be accompanied by details to
support the proposal & enable tha assessment
manager, referral agencies and any person viewing
the application during public scrutiny or public
notification to understand the scope of the proposal
and any potential impact.

 

25,

Plans/drawings/reports accompanying this application:
Plan / Drawing / Report Number

V9O62Q6Er1 Nbc dt

 

 

 

 

 

 

 

 

 

PLEASE NOTE: The assessment manager may refuse to accept an application that, at the time of lodgement, fails to provide all applicable information required by Part A
and any other relevant part of Form 1.

 

OFFICE USE ONLY (applicable to assessment manager's)

 

 

 

 

Date ofengagement. / /

 

Accreditation Number:

 

DATE RECEIVING OFFICER'S 4 REFERENCE |
[ree ® (7oe RECEIVED | (sj2(e) NAMEIS IPD Kroon ag) NUMBERS | a [ oe | |
Notification of Engagement of Private Certifier (Optional format) v
To. Council. | have been engaged as the private cerlifier for the building work referred to in this application.

 

__ Name: Signature: