DA Form 1 & Plan

 

 

Yes — a copy of the receipted QLeave form is attached to this development application

No —1, 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 (e.g. building and construction work is less than $150,000 excluding GST)

 

Amount paid Date paid (dd/mm/yy) QLeave levy number

$ M/E:

(Yes — show cause or enforcement notice is attached
No

 

 

 

 

   

 

 

 

 

(1 Yes — the required attachment (form ESR/2015/1791) for an application for an environmental authority
accompanies this development application, and details are provided in the table below

No

Note: Application for an environmental authority can be found by searching “ESR/2015/1791" as a search term 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:

 

 

 

 

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

 

 
    
    
    
     
    

(1 Yes — Form 69: Notification of a facility exceeding 10% of schedule 15 threshold is attached to this development
application
No

Note: See www.business.gld.gov.au for further information about hazardous chemical notifications.

(J Yes — this development application includes written confirmation from the chief executive of the Vegetation
Management Act 1999 (s22A determination)
No

Note: 1. Where a development application for operational work or material change of use requires a s22A determination and this is not
included, the development application is prohibited development.

2. See https/Avww.gid.gov.au/environment/and/vegetation/applying for further information on haw to obtain a s22A determination.

(1 Yes - | acknowledge that an environmental offset must be provided for any prescribed activity assessed as
haying a significant residual impact on a prescribed environmental matter

No
Note: The environmental offset section of the Queensland Government's website can be accessed at www.gid.gov.au for further information on

environmental offsets.