08/0252 - Prescribed Tidal Works - Transport Type 6 - Commercial Marine [As Published] · 142008.252

INTEGRATED PLANNING ACT_1997

Land owner’s consent (if applicable) 20.

Section 3,2,1(3) of the IPA prescribas that an
application must contain, ar be supported by, the
written consent of the land owner/s, if the application
involves:

(i) a material change of use;

(ii) reconfiguration of a lot;

(ii) work on land betow high-water mark & rot within a
canal as defined under the Coastal Protection and
Management Act 1995;0r

(iv) work on rail corridor and defined under the
Transport Infrastructure Act 1994,

Section 3.8.1{2){a) of the IPA provides that

landowners consent is not required for a mobile or

temporary ERA.

For more information refer to Guide 1.

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

 

 

Name Signature Date |
i
wo © fo, of
es
“Ww po Pe

yrs ores .

 

 

 

 

 

 

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}(i)) of the IPA prescribes that an

application cannot be taken to be properly made 22.

 

without evidence of the resource entitlement.

Advice for completing Q21 & 22

Refer to schedute 10 of the integrated Planning
Regulation 1998 ihat prescribes the nature of evidence
required by the State in support of the lodging of this
development application.

Advice for completin 23.

The Information in (i) - (v) is mandatory if evidence is
required under 022 (ii) ar (iii) 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) altows the resource manager to limit
the time the evidence may be used. Q23 (vi) must be
completed if the evidence is time limited,

Does this application involve a State resource prescribed under a regulation (other than involving
quarry material on State coastal land under the Coastal Protection and Management Act 1995)?

LINO - go to a24 El YES - go to. a22

This application is accompanied by evidence: (tick applicable box)
CO (i) of the allocation of, or entitlement to, the resource - attach evidence and go to Q23(v)

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
to Q23

& (iii) 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 023

Evidence of the resource entitlement:
(i) Resource entitlement / authority details
[ Lot 4 on SPiInAOeY |

(vil) Official stamp of the department

administering the resource (if
applicable}

  

(ii) Name of delegated officer . &
Rene. cory hp fee,
(iii) Position of delegated officer "Or, Cre,
ae,
"0
(iv) Signature of delegated officer Ny wr, ye
"al poor
Soup hag

 

 

 

[adifofroos

date of evidence (if applicable)

 

 

Assessment triggers 24.

This checklist does pot apply if the application requires
the completion of Parts A and B of the Form onty. It
must be compieted for all other applications.

ts the IDAS Assessment Checklist completed and attached to this application?

YES (11 NO - the assessment manager may refuse to accept this application on the

grounds that the application has not been properly made

 

Plans / drawings / reports 25.

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

 

Plans/drawings/reports accompanying this application:

 

 

 

Plan / Drawing / Report Number Title Date

JSP-CP-490D LAYOUT & DETAILS 27104/07
(i) JsP-cp4giOSS~*~*~*«~CELEVATIONN, =O, 27104107
“(iy Jsp-cpagarSS”~=«* Ste LAYOUT. 27/04/07
‘(wy JspcpagsaSSC* CATWALK 27104107

 

 

 

 

 

 

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)

| FEE ®)] RECEIVED

RECEIVING OFFICER'S REFERENCE
NAME/S NUMBERIS.

 

To.

Date ofengagement’ / /

 

Notification of Engagement of Private Certifier (Optionat format)

Accreditation Number.

Council. | have been engaged as the private certifier for the building work referred to in this application,
1

___ Name; Signature: