Development Application Removal of Vegetation - OPW13/0111

12. Is the payment of a portable long service leave levy applicable to this application? (Refer to notes at the end
of this form for more information.)


~        No-go to question 14          DYes

13. Has the portable long service leave levy been paid? (Referto notes at the end of this form for more
information.)


o        No


o        Yes-complete Table N and submit with this application the yellow local government/private certifier’s copy of the
         receipted QLeave form

Table ~

Amount paid                Date paid         QLeave project number (6digit number starting with A, B, E, L or P)

                           (dd/mm/yy)




14. Has the local government agreed to apply a superseded planning scheme to this application under section
96 of the Sustainable Planning Act 20091


rn       No


o Yes--please provide details below

Name of local government                            Date of written notice given    Reference number of written notice given
                                                   by local government              by local government (if applicable)
                                                   (dd/mm/yy)




    15. List below all of the forms and supporting information that accompany this application (Include alllDAS
    forms, checklists, mandatory supporting information etc. that will be submitted as part of this application. Note: this
    question does not apply for applications made online using Smart eDA)


Description of attachment or title of attachment                                              Method of lodgement to
                                                                                              assessment manager




16.Applicant’s declaration
       /


    By making this application, I declare that all information in this application is true and correct (Note:it is unlawful to
provide false or misleading information.)




6                                                                                                  IDAS form 1-Application details
                                                                                                     Version 2.0 17 December 2012