Development Application - Part 1 of 2 - Covering Letter, IDAS Forms 1, 6 & 23 - OPW13/0069

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    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? (Refer to 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 governmenUprivate certifier’s copy of the
          receipted OLeave form

Table N

Amount paid                Date paid         OLeave 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 Has the local government agreed to apply a superseded planning scheme to this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 2009?


    IX!   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 all IDAS
    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


          As    o-tro.c.hed




    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 2.017 December 2012