Development Application Part 1 of 2 IDAS Forms 1 & 5 & 6 MCU11/0168 & OPW11/0257

QLEAVE NOTIFICATION AND PAYMENT (for completion by assessment manager or private certifier if applicable)

                                                                                Date receipted
                                        QLeave Project   Amount                 form sighted by Name of officer who
              Description of the work                               Date paid
                                        Number           paid ($)               assessment       sighted the form
                                                                                manager

        1

The Sustainable Planning Act 2009 (SPA) is administered by the Department of Infrastructure and Planning. This
form and all other required application materials should be sent to your assessment manager and any referral
agencies.