20201221085022221 · OPW21/0001

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Department of Infrastructure, Local Government and Plann

 

PART 2—LOCATION DETAILS

3) Location of the premises (complete 3.1) or 3.2), and 3.3) as applicable)
Note: Provide details below and attach a site plan for any or all premises part of the development application. For further information, see DA Forms

Guide: Relevant plans.
3.1) Street address and lot on plan

[4 Street address AND lot on plan (ai! lots must be listed), or

CO Street address AND lot on plan for an adjoining or adjacent property of the premises (appropriate for development in water
but adjoining or adjacent to land e.g. jetty, pontoon; all lots must be listed).

 

 

 

 

 

 

 

 

Unit No. | Street No. | Street Name and Type Suburb
7
2) 14 Bortlslomes Court Zooroy
Postcode | Lot No. Plan Type and Number (e.g. RP, SP) Local Govérnment Area(s)
Unit No. | Street No. | Street Name and Type Suburb
b)
Postcode | Lot No. Plan Type and Number (e.g. RP, SP) Local Government Area(s)

 

 

 

 

 

3.2) Coordinates of premises eerie ag Pee ant in remote areas, over part of a lot or in water not adjoining or adjacent to land e.g.

channel dredging in Moreton Bay)
Note: Place each set of coordinates in a separate row. Ome Po Cel Reele Ce MARCO LOMO LCE Ee

C1 Coordinates of premises by longitude and latitude

 

 

 

 

 

 

 

Longitude(s) Latitude(s) Datum Local Government Area(s) (if applicable)
L] wess4
CL] GDA94
(J Other:
LJ Coordinates of premises by easting and northing
Easting(s) Northing(s) Zone Ref. | Datum Local Government Area(s) (if applicable)
[] 54 CO] wess4

(155 (1 GDA94
(156 (J Other:

 

 

 

 

3.3) Additional premises

 

CJ Additional premises are relevant to this development application and their details have been attached in a schedule
re application
Not required

4) Identify any of the following that apply to.the premises.and provide any relevant details

 

   

(1 In or adjacent to a water body or watercourse or in or above an aquifer

 

Name of water body, watercourse or aquifer:
(J On strategic port land under the Transport Infrastructure Act 1994

 

 

Lot on plan description of strategic port land:

 

Name of port authority for the lot:
(J Ina tidal area

 

 

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

 

 

Name of port authority for tidal area (if applicable):
( On airport land under the Airport Assets (Restructuring and Disposal) Act 2008
Name of airport: |

 

 

 

(J Listed on the Environmental Management Register (EMR) under the Environmental Protection Act 1994
EMR site identification: |

 

 

 

 

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Department of infrastructure, Local Government and Plann

 

 

(7 Listed on the Contaminated Land Register (CLR) under the Environmental Protection Act 1994
CLR site identification:

 

 

 

     
 

 
 

5) Are there any existing easements over the premises?

Nee eMC T CORMIER CCUM MLR Mme Tek ONE Ur RTT ME mm ee) Ce OR Mie
they may affect the proposed development, see DA Forms Guide.

 
 

(1 Yes — All easement locations, types and dimensions are included in plans submitted with this development
application
Ao

PART 3 — DEVELOPMENT DETAILS

 

 

Section 1 — Aspects of development
6.1) Provide details about the first development aspect

 

a) What is the type of development? (tick only one box)

 

CJ Material change of use (1 Reconfiguring a fot C1 Operational work (1 Building work
b) What is the approval type? (tick only one box)
(J Development permit C] Preliminary approval L] Preliminary approval that includes

a variation approval

 

c) What is the level of assessment?
( Code assessment C1 Impact assessment (requires public notification)

 

d) Provide a brief description of the proposal (e.g. 6 unit apartment building defined as multi-unit dwelling, reconfiguration of 1 lot into 3
Jots):

Drv vewoy

e) 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.

wt Relevant plans of the proposed development are attached to the development application
6.2) Provide details about the second development aspect 7

a) What is the type of development? (tick only one box)

 

 

J] Material change of use . ( Reconfiguring a lot (1) Opérationial work C] Building work
b) What is the approval type? (tick only one box)
(1 Development permit C1 Preliminary approval (J Preliminary approval that includes a variation

 

approval
c) What is the level of assessment? me
(1 Code assessment C1 impact assessment (requires public notification)

 

d) Provide a brief description of the proposal (e.g. 6 unit apartment building defined as multi-unit dwelling, reconfiguration of 1 fot into 3 lots)

e) 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. as

(J Relevant plans of the proposed development are attached to the development application

6.3) Additional aspects of development

() Additional aspects of development are relevant to this development application and the details for these aspects
het see be required under Part 3 Section 1 of this form have been attached to this development application

Not required

 

 

 

 

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Department of Infrastructure, Local Government and Piann

 

Section 2 — Further development details
7) Does the proposed development application involve any of the following?

 

 

 

 

 

Material change of use (1 Yes — complete division 1 if assessable against a local planning instrument
Reconfiguring a lot (1 Yes — complete division 2

Operational work CO Yes — complete division 3

Building work (1 Yes — complete DA Form 2 - Building work details

 

 

Division 1 — Material change of use
Note: This division is only required to be completed if any part of the development application involves a material change of use assessable against a local
planning instrument.

8.1) Describe the proposed material change ofuse -. :

 

Provide a general description of the Provide the planning scheme definition | Number of dwelling Gross floor
proposed use (include each definition in a new row) units (if applicable) area (m?)
"(if applicable):

 

 

 

   

 

 

 

Pe heehee nk natenciiin:
CO Yes
Mio

Division 2 - Reconfiguring a lot
Note: This division is only required to be completed if any part of the development application involves reconfiguring a lot.

9.1) What is the total‘number of existing lots making up the errata

dings on the premises?

   

 

 

 

 

 

 

  

oe el Ls Re lm ames Receile oes ag Eye ces)

 

 

 

 

((] Subdivision (complete 10) (1 Dividing land into parts by agreement (complete 11)
(J Boundary realignment (complete 12)) (Creating or changing an easement giving access to a lot from
a construction road (complete 13))

 

  
 
  

10) Subdivision ; 2
10.1) For this development, how many lots are’ being

    
    

qeyeeice and what is the intended use of those lots:

 

     
 
 
    

Intended use of lots created Residential Commercial Industrial Other, please specify:

 

 

 

Number of lots created
RP remedies tke ks

C1 Yes — provide additional details below
lo

How many stages will the works include? ca

What stage(s) will this development application
apply to?

 

 

 

 

 

 

 

 

     
 

11) Dividing land into parts by agreement — how many parts are being created and what is the intended use of the
parts?

Intended use of parts created

  
   

     
 
   

  

     

Residential Commercial Industrial Other, please specify:

 

 

 

 

Number of parts created

 

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Department of Infrastructure, Local Government and Plann

 

sPaRaleiecin accel ian

  
 
 

42.1) What are the current and proposed areas for each lot comprising the org
Current lot Proposed lot

   

 

Lot on plan description Area (m?) Lot on plan description Area (m?)

 

 

 

 

 

 

 

 

12.2) What is the reason for the boundary realignment?

 

  

13) What are the dimensions and nature of any existing easements being changed and/or any proposed easement?
(attach schedule if there are more than two easements)

Existing or Width (m) | Length (m) | Purpose of the easement? (e.g. Identify the land/lot(s)
proposed? pedestrian access) benefitted by the easement

         
   

  

 

 

 

 

 

 

 

 

 

Division 3 — Operational work
Note: This division is only required to be completed if any part of the develo,

14.1) What is the nature of the operational work?

(J Road work C Stormwater (J Water infrastructure
L] Drainage work CO Earthworks CO Sewage infrastructure
(1 Landscaping C] Signage (1 Clearing vegetation

(A Other — please specify: On VEIWRAa S

pment application involves operational work.

   
   
 
    
   
 
  

    
    

 

   
 

14.2) Is the operational work necessary to facilitate the creation of new lots? (e.g. subdivision)

 
 

CJ Yes — specify number of new lots:
MANo

144.3) What is the monetary value of the proposed operational work? (include GST, materials and labour)

$

 

  
    

 

 

PART 4 — ASSESSMENT MANAGER DETAILS

15) Identify the assessment manager(s) who will be assessing this development application

 

16) Has the local government agreed to apply a superseded planning scheme for this development application?

(] Yes — a copy of the decision notice is attached to this development application

["] Local government is taken to have agreed to the superseded planning scheme request — relevant documents
attached

(No
PART 5 — REFERRAL DETAILS

 

     
       
    

17) Do any aspects of the proposed development require referral for any referral requirements?
Note: A development application will require referral if prescribed by the Planning Regulation 2017.

[7 No, there are no referral requirements relevant to any development aspects identified in this development
application — proceed to Part 6

Matters requiring referral to the chief executive of the Planning Regulation 2017:

CO Clearing native vegetation
([] Contaminated land (unexploded ordnance)

 
 
 

 

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Department of Infrastructure, Local Government and Plann

 

(1 Environmentally relevant activities (ERA) (only if the ERA have not been devolved to a local government)

Ci Fisheries — aquaculture

(] Fisheries — declared fish habitat area

(1 Fisheries — marine plants

(1 Fisheries — waterway barrier works

CJ Hazardous chemical facilities

(J Queensland heritage place (on or near a Queensiand heritage place)

UJ Infrastructure — designated premises

( Infrastructure — state transport infrastructure

(J Infrastructure — state transport corridors and future state transport corridors

(J Infrastructure — state-controlled transport tunnels and future state-controlled transport tunnels
(1 Infrastructure — state-controlled roads

(J Land within Port of Brisbane's port limits

(] SEQ development area

(SEQ regional landscape and rural production area or SEQ Rural living area — community activity
(J SEQ regional landscape and rural production area or SEQ Rural living area — indoor recreation
(J SE@ regional landscape and rural production area or SEQ Rural living area — residential development
(1 SEQ regional landscape and rural production area or SEQ Rural living area — urban activity

(1 Tidal works or works in a coastal management district

C urban design

(] Water-related development — taking or interfering with water

(1 Water-related development — removing quarry material (from a watercourse or lake)

(] Water-related development — referable dams

(J Water-related development — construction of new levees or modification of existing levees (category 2 or 3 levees only)
(J Wetland protection area

 

Matters requiring referral to the local government:

 

C Airport land
(1 Environmentally relevant activities (ERA) (only if the ERA have been devolved to local government)
LD Local heritage places

 

Matters requiring referral to the chief executive of the distribution entity or transmission entity:
C Electricity infrastructure

 

Matters requiring referral to:
© The chief executive of the holder of the licence, if not an individual
e The holder of the licence, if the holder of the licence is an individual
CJ Oil and gas infrastructure

 

Matters requiring referral to the Brisbane City Council:
(J Brisbane core port land

 

Matters requiring referral to the Minister under the Transport Infrastructure Act 1994:
(J Brisbane core port land
(2 Strategic port land

 

Matters requiring referral to the relevant port operator:
(Brisbane core port land (below high-water mark and within port limits)

 

Matters requiring referral to the chief executive of the relevant port authority:
(Land within limits of another port

 

Matters requiring referral to the Gold Coast Waterways Authority:
(J Tidai works, or development in a coastal management district in Gold Coast waters

 

Matters requiring referral to the Queensland Fire and Emergency Service:

 

 

 

(1 Tidal works, or development in a coastal management district

 

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DA Form 1 — Development Application details
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Department of Infrastructure, Local Government and Plann

 

 

SE) Bae CR TN ARS cue Ue Cu a oe Cre RCC o1 LoL developm

 

it application?
C1 Yes - referral response(s) received and listed below are attached to this development application
No

Referral requirement Referral agency Date of referral response

 

 

 

 

 

 

Identify and describe any changes made to the proposed development application that was the subject of the referral
response and the development application the subject of this form, or include details in a schedule to this development
application (if applicable).

 

 

 

 

PART 6 — INFORMATION REQUEST

 
   

 
    
      
 
 
    
     

19) Information request under Part 3 of the DA Rules

[WI agree to receive an information request if determined necessary for this development application
(J | do not agree to accept an information request for this development application
Note: By not agreeing to accept an information request |, the applicant, acknowledge:

« that this development application will be assessed and decided based on the information provided when making this development application and
the assessment manager and any referral agencies relevant to the development application are not obligated under the DA Rules to accept any
additional information provided by the applicant for the development application unless agreed to by the relevant parties

© Part 3 of the DA Rules will still apply if the application is an application listed under section 11.3 of the DA Rules.
Further advice about information requests is contained in the DA Forms Guide.

 

PART 7 — FURTHER DETAILS

   

20) Are there any associated development Piven (on eke current approvals?

(J Yes — provide details below or include details in a schedule to this development application
lo

(e.g. a preliminary approval)

 

 

List of approval/development Reference number Date Assessment manager
application references

 

C1 Approval
(] Development application

(Approval
(J Development application

 

 

 

 

 

 

         

21) Has the portable long service leave levy been ryokan
ee operational work) oon

(1 Yes - the yellow local government/private certifier’s copy of the receipted QLeave form is attached to this
development application

(No -|, the applicant will provide evidence that the portable long service leave levy has been paid before the
assessment manager decides the development application. | acknowledge that the assessment manager may give a
development approval only if | provide evidence that the portable long service leave levy has been paid

Not applicable
Amount paid Date paid (dd/mm/yy) QLeave levy number (A, B or E)
$

ly Pea iec CR Oke yale irae ec enea en Lem Mee mee

 

 

 

 

 

 

 

22) Is this development application in response to a show cause notice or required as a result of an enforcement notice?

(1 Yes — show cause or enforcement notice is attached
No

 
   

 

 

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Department of Infrastructure, Local Government and Plann

 

PAB a Va cl oelocln mos? (Rada)

Environmentally relevant activities

23.1) Is this development application also taken to be an application for an environmental authority for an
Environmentally Relevant Activity (ERA) under section 115 of the Environmental Protection Act 1994?

(1 Yes - the required attachment (form EM941) for an application for an environmental authority accompanies this
devglopment application, and details are provided in the table below
“No

Note: Application for an environmental authority can be found by searching "EM941” at www.gid.gov.au. An ERA requires an environmental authority
to operate. See www.business.qid.gov.au for further information.

 

 

Proposed ERA number: Proposed ERA threshold:

 

Proposed ERA name:

 

 

 

 

g Multiple ERAs are applicable to this development application and the details have been attached in a schedule
to this development application.

       
  
    
 

Hazardous chemical facilities
23.2) Is this development application for a hazardous chemical facility?
(1 Yes — Form 69: Notification of a facility exceeding 10% of schedule 15 threshold is attached to this development

applisation
f/f

Note: See www.justice.gld, gov.au for further information.

 

Clearing native vegetation

23.3) Does this development application involve clearing native vegetation that requires written confirmation the chief
executive of the Vegetation Management Act 1999 is satisfied the clearing is for a relevant purpose under section 22A
of the Vegetation Management Act 1999?

(1 Yes — this development application is accompanied by written confirmation from the chief executive of the

on Management Act 1999 (s22A determination) .
No

Note: See www.gid.gov.au for further information.

Environmental offsets

23.4) Is this development application taken to be a prescribed activity that may have a significant residual impact on a
prescribed environmental matter under the Environmental Offsets Act 2014?

  
    
 
 
   

(1 Yes — | acknowledge that an environmental offset must be provided for any prescribed activity assessed as having a
een residual impact on a prescribed environmental matter
io

Note: The environmental offset section of the Queensland Government's website can be accessed at www.qld.gov.au for further information on
environmental offsets.

   
 
  
 
    
     
   
 

Koala conservation

 

23.5) Does this development application involve a material change of use, reconfiguring a lot or operational work within
an assessable development area under Schedule 10, Part 10 of the Planning Regulation 2017?

ae

No

Note: See guidance materials at www.ehp.qld.gov.au for further information.
Water resources

23.6) Does this development application involve taking or interfering with artesian or sub artesian water, taking or
interfering with water in a watercourse, lake or spring, taking overland flow water or waterway barrier works?

ee the relevant template is completed and attached to this development application
No

Note: DA templates are available from www.dilgp.qld.gov.au.

23.7) Does this application involve taking or interfering with artesian or sub artesian water, taking or interfering
with water in a watercourse, lake or spring, or taking overland flow water under the Water Act 2000?

  

      

C1 Yes — | acknowledge that a relevant water authorisation under the Water Act 2000 may be required prior to

 

 

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Department of Infrastructure, Local Government and Plann

 

 

conmpiencing development
No

Note: Contact the Department of Natural Resources and Mines at www.dnrm.gid.gov.au for further information.

    
    

Marine activities
23.8) Does this development application involve aquaculture, works within a Clee MCMC Cle kt Rm CLC Ce
disturbance or destruction of marine plants?

(J Yes — an associated resource allocation authority is attached to this development application, if required under the
Fisheries Act 1994

fio

Note: See guidance materials at www.daf.qid.gov.au for further information.

ee R MUP CUPLOM (e LIRR O Eee TR EL

23.9) Does this development application involve the removal of quarry materials from a watercourse or lake under
ICM emma OL 6 Og

(J Yes — | acknowledge that a quarry material allocation notice must be obtained prior to commencing development
Defic

Note: Contact the Department of Natural Resources and Mines at www.dnrm.qid.gov.au for further information.
Quarry materials from land under tidal waters

23.10) Does this development application involve the removal of quarry materials from land under tidal water under
the Coastal Protection and Management Act 1995?

Se —| acknowledge that a quarry material allocation notice must be obtained prior to commencing development
lo

Note: Contact the Department of Environment and Heritage Protection at www.ehp.gid.gov.au for further information.
Lele ee ELE

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)?

(1 Yes ~ the ‘Notice Accepting a Failure Impact Assessment’ from the chief executive administering the Water Supply
Act attached to this development application

Oo
Note: See guidance materials at www.dews. qid.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?

(J 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}

oe A certificate of title
No

Note: See guidance materials at www.ehp.qid.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?

(1 Yes — details of the heritage place are provided in the table below
uo

Note: See guidance materials at www.ehp.qid.gov.au for information requirements regarding development of Queensland heritage places.

 

Name of the heritage place: Place ID:
ETC

23.14) Does this develapment application involve a material change of use Iola Melce Ui ied

 

(J Yes — this development application demonstrates how the proposal meets the code for a development application
for a prothel under Schedule 3 of the Prostitution Regulation 2014
lo

 

 

 

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Department of Infrastructure, Local Government and Plann

 

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
whe Act 1994 (subject to the conditions in section 75 of the Transport Infrastructure Act 1994 being satisfied)
No

 

PART 8 — CHECKLIST AND APPLICANT DECLARATION

   

PERN le eaie-1 8) eet els
| have identified the assessment manager in question 15 and all relevant referral

 

requirement(s) in question 17 C1 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— C1 Yes

Building work details have been completed and attached to this development application Sot 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 oO 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 We
Note: Relevant plans are required to be submitted for all aspects of this development application. For further Ye

information, see DA Forms Guide: Relevant plans.

The portable long service leave levy for QLeave has been paid, or will be paid before a Oy
development permit is issued (see 21)) jot applicable

 

 

 

 

25) Applicant declaration

[Mf By making this development application, | declare that all information in this development application is true and

correct
Where an email address is provided in Part 1 of this form, | 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 relevant 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:

e 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

e 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.

 

 

 

 

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Department of Infrastructure, Local Government and Plann

 

PART 9 — FOR OFFICE USE ONLY

Date received: [isd Reference number(s): | |
Notification of engagement of alternative assessment manager

Prescribed assessment manager

 

 

 

Name of chosen assessment manager

 

Date chosen assessment manager engaged

 

Contact number of chosen assessment manager

 

Relevant licence number(s) of chosen assessment
manager

 

QLeave notification and payment

 

Note: For completion by assessment manager if applicable

Description of the work

 

QLeave project number
Amount paid ($)
Date paid

 

 

 

Date receipted form sighted by assessment manager

 

 

 

Name of officer who sighted the form

 

 

The Planning Act 2016, the Planning Regulation 2017 and the DA Rules are administered by the Department of
Infrastructure, Local Government and Planning. This form and all other required development application materials should
be sent to the assessment manager.

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Site Diagram including proposed dimensions must be provided

 

 

Gage

 

Poth

 

 

 

 

 

 

OFFICE USE ONLY

 

 

 

 

 

Privacy

Council will use any personal information provided for the intended purpose only and for remaining in contact with you. Council
is authorised to collect this information in accordance with the Local Government Act 2009 and other Local Government Acts.
Your personal information is only accessed by persons authorised to do so. Your personal information is dealt with in
accordance with council's privacy policy.