02.2 - Da Form 1 - S63 · OPW18/0008

☐ Contaminated land (unexploded ordnance)
☐ Environmentally relevant activities (ERA) (only if the ERA have not been devolved to a local government)
☐ Fisheries – aquaculture
☐ Fisheries – declared fish habitat area
☐ Fisheries – marine plants
☐ Fisheries – waterway barrier works
☐ Hazardous chemical facilities
☐ Queensland heritage place (on or near a Queensland heritage place)
☐ Infrastructure – designated premises
☐ Infrastructure – state transport infrastructure
☐ Infrastructure – state transport corridors and future state transport corridors
☐ Infrastructure – state-controlled transport tunnels and future state-controlled transport tunnels
☐ Infrastructure – state-controlled roads
☐ Land within Port of Brisbane’s port limits
☐ SEQ development area
☐ SEQ regional landscape and rural production area or SEQ Rural living area – community activity
☐ SEQ regional landscape and rural production area or SEQ Rural living area – indoor recreation
☐ SEQ regional landscape and rural production area or SEQ Rural living area – residential development
☐ SEQ regional landscape and rural production area or SEQ Rural living area – urban activity
☐ Tidal works or works in a coastal management district
☐ Urban design
☐ Water-related development – taking or interfering with water
☐ Water-related development – removing quarry material (from a watercourse or lake)
☐ Water-related development – referable dams
☐ Water-related development – construction of new levees or modification of existing levees (category 2 or 3 levees only)
☐ Wetland protection area
Matters requiring referral to the local government:
☐ Airport land
☐ Environmentally relevant activities (ERA) (only if the ERA have been devolved to local government)
☐ Local heritage places
Matters requiring referral to the chief executive of the distribution entity or transmission entity:
☐ Electricity infrastructure
Matters requiring referral to:
   The chief executive of the holder of the licence, if not an individual
   The holder of the licence, if the holder of the licence is an individual
☐ Oil and gas infrastructure
Matters requiring referral to the Brisbane City Council:
☐ Brisbane core port land
Matters requiring referral to the Minister under the Transport Infrastructure Act 1994:
☐ Brisbane core port land
☐ Strategic port land
Matters requiring referral to the relevant port operator:
☐ Brisbane core port land (below high-water mark and within port limits)
Matters requiring referral to the chief executive of the relevant port authority:
☐ Land within limits of another port
Matters requiring referral to the Gold Coast Waterways Authority:
☐ Tidal works, or development in a coastal management district in Gold Coast waters

                                                                                                                              Page 6
                                                                                            DA Form 1 – Development Application details
                                                                                                              Version 1.0—3 July 2017