2. DNRME Owners Consent

Page 2

Further, please note that the above consent will expire on 13 April 2022. Should the
development application not be lodged with the assessment manager prior to this date, you or
your client will be required again to lodge the DA Form 1 and any attachments with this
Department with a further request for owner's consent - any further request will need to be
reconsidered by the Department.

It is also advised that any land use activities must comply with the Aboriginal Cultural Heritage
Act 2003 or the Torres Strait Islander Heritage Act 2003.

Finally, owner’s consent is required under the Planning Act 2016 to enable the application to be
considered properly made for lodging with the assessment manager and is a completely
separate process to assessment of the application under the Planning Act 2016.

Accordingly, the State may act at a later date as assessment manager in the assessment of the
development application - providing owner’s consent will not influence any role the State may
have in this development assessment.

If you wish to discuss this matter, please contact Leanne Hunter on 4447 9165.

All future correspondence relative to this matter is to be referred to the contact Officer at the
address below or by email to Townsville. [email protected] . Any hard copy
correspondence received will be electronically scanned and filed. For this reason, it is
recommended that any attached plans, sketches or maps be no larger than A3-sized.

Please quote reference number 2021/003013 in any future correspondence.

Yours sincerely

Reb dev)

Deanna Holder

Senior Land Officer

A duly authorised delegate of the Minister

under the current Land Act (Ministerial) Delegation

Page 3

DA Form 1 — Development application details
Approved form (version 1.3 effective 28 September 2020) made under section 282 of the Planning Act 2016.

 

This form must be used to make a development application involving code assessment or impact assessment,
except when applying for development involving only building work,

For a development application involving building work only, use DA Form 2 — Building work details.

For a development application involving building work associated with any other type of assessable development
(i.e. material change of use, operational work or reconfiguring a lot), use this form (DA Form 1) and parts 4 to 6 of

DA Form 2 — Building work details.

Unless stated otherwise, all parts of this form must be completed in full and all required supporting information must

accompany the development application.

One or more additional pages may be attached as a schedule to this development application if there is insufficient
space on the form to include all the necessary information.

 

This form and any other form relevant to the development application must be used to make a development
application relating to strategic port land and Brisbane core port land under the Transport Infrastructure Act 1994,
and airport land under the Airport Assets (Restructuring and Disposal) Act 2008. For the purpose of assessing a
development application relating to strategic port land and Brisbane core port land, any reference to a planning
scheme is taken to mean a land use plan for the strategic port land, Brisbane port land use plan for Brisbane core

 

port land, or a land use plan for airport land.

 

 

Note: All terms used in this form have the meaning given under the Planning Act 2016, the Planning Regulation 2017, or the Development

Assessment Rules (DA Rules).

PART 1 — APPLICANT DETAILS

1) Applicant details

 

Applicant name(s) (individual or company full name)

The Nature Conservancy Ltd

 

Contact name (only applicable for companies)

Craig Bohm (TNC) / Bobbie Corbett (ICM) as lodger

 

 

 

 

 

 

 

 

Postal address (P.O. Box or street address) PO Box 833

Suburb North Melbourne

State Victoria

Postcode 3051

Country Australia

Contact number (07) 5564 0564

Email address (non-mandatory) [email protected]
Mobile number (non-mandatory) 0407 664 483

 

Fax number (non-mandatory)

 

Applicant’s reference number(s) (if applicable)

 

Noosa Oyster Project

 

 

 

Yes — the written consent of the owner(s) is attached to this development application
LJ No — proceed to 3)

 

 

3) Queensland
Government

  

Page 4

PART 2 —LOCATION DETAILS

( Street address AND lot on plan (ali lots must be listed), Or

EJ Street address AND lot on plan for an adjoining or adjacent property of the premises (appropriate for development in
water but adjoining or adjacent to land e.g. jetty, pontoon. All lots must be listed).

Unit No. | StreetNo. | Street Name and Type Suburb
USL adjacent to Lots in attached Schedule 1
Postcode | Lot No. Plan Type and Number (e.g. RP, SP} Local Government Area(s)

Unit No. | StreetNo. | Street Name and Type Suburb

b)

Postcode | Lot No. Plan Type and Number (e.g. RP, SP} Local Government Area(s)

LO Coordinates of premises by longitude and latitude
| Longitude(s) Latitude(s) Datum Local Government Area(s) (if applicable)
C1 wese4
OO Gpag4
CJ Other:
C1 Coordinates of premises by easting and northing
| Easting(s) —_| Northing(s) Zone Ref. | Datum Local Government Area(s) (if applicable)
os4 Clwesea Noosa Shire
L155 CO spag4
(156 (1 Other:

[X] Additional premises are relevant to this development application and the details of these premises have been
attached in a schedule to this development application

CI Not required

 

      

4) Identify any of the following that apply to the premises and provide any relevant details
In or adjacent to a water body or watercourse or in or above an aquifer

Name of water body, watercourse or aquifer: Noosa River

LD On strategic port land under the Transport infrastructure Act 1994

Lot on plan description of strategic port land:
Name of port authority for the lot:

KI In a tidal area

Name of local government for the tidal area (if applicable): Noosa Shire Council
Name of port authority for tidal area (if applicable):
0 On airport land under the Airport Assets (Restructuring and Disposal) Act 2008
Name of airport:

 

 

 

 

 

 

 

 

 

 

 

 

 

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DA Form 1 — Development application details
Version 1.3— 28 September 2020

Page 5

 

C1 Listed on the Environmental Management Register (EMR) under the Environmental Protection Act 1994
EMR site identification: [
[J Listed on the Contaminated Land Register (CLR) under the Environmental Protection Act 1994
CLR site identification: |

 

 

 

 

 

 

  
   

5) Are there any existi
eh coat E Terre urately. For further info:
y y {elle ne Pree a Gt
X] Yes - All easement locations, types and dimensions are included in plans submitted with this development
application
LINo

PART 3 —- DEVELOPMENT DETAILS

   

 

 

 

Section 1 — Aspects of development

 

6.1) Provide details about the first development aspect

a) What is the type of development? (tick only one box)

 

 

 

 

 

 

LC Material change of use [[] Reconfiguring a lot KX] Operational work (1 Building work

b) What is the approval type? (tick only one box)

KX] Development permit LO Preliminary approval C] Preliminary approval that includes a variation approval

c) What is the level of assessment?

[KX] Code assessment LO Impact assessment (requires public notification)

d) Provide a brief description of the proposal (e.g. 6 unit apartment building defined as multi-unit dwelling, reconfiguration of 1 lot into 3
lots):

 

Habitat restoration / enhancement in the Noosa River.

e) Relevant plans

Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms quide:
Relevant plans.

J Relevant plans of the proposed development are attached to the development application

 

 

 

§.2) Provide detail It the second development aspect
a) What is the type of development? (tick only one box)

 

LD Material change of use [[] Reconfiguring a lot LD Operational work (1 Building work

b) What is the approval type? (tick only one box)

C1 Development permit L Preliminary approval (Preliminary approval that includes a variation approval
c) What is the level of assessment?

LJ Code assessment LD Impact assessment (requires public notification)

d) Provide a brief description of the proposal (e.g. 6 unit apartment building defined as multi-unit dwelling, reconfiguration of 1 lot into 3
lots):

 

 

 

 

 

 

 

e) Relevant plans
Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms Guide:
Relevant plans.

CJ Relevant plans of the proposed development are attached to the development application

 

 

6.3) Additional aspects of deve

LJ Additional aspects of development are relevant to this development application and the details for these aspects
that would be required under Part 3 Section 1 of this form have been attached to this development application

KX] Not required

 

 

 

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DA Form 1 ~ Development application details
Version 1.3— 28 September 2020

Page 6

Section 2 — Further development details

 

) Does the proposed development application involv
Material change of use

any of the following?

OO Yes — complete division 1 if assessable against a local planning instrument

 

Reconfiguring a lot

LD Yes — complete division 2

 

Operational work

XX] Yes — complete division 3

 

 

Building work

C1 Yes — complete DA Form 2 — Building work details

 

 

Division 1 — Material change of use

Note: This division is only required to be completed if any part of the development application involves a material change of use assessable against a

local planning instrument.

   

8.1) Describe the proposed material change of use

 

Provide a general description of the Provide the planning scheme definition | Number of dwelling | Gross floor
proposed use (include each definition in a new row) units (if applicable) area (m?)
(if applicable)

 

 

 

 

8.2) Does the proposed use involve the use of existing buildings on the premises?
OJ Yes

 

 

 

 

 

LINo

 

 

Division 2 — Reconfiguring a lot

Note: This division is only required to be completed if any part of the development application involves reconfiguring a lot

9.1) What is the total number of existing lots making up the premises?

i pva BA etcle MULT Cle men alm (OME LeceLeL CLUE UCLA Neae eae Se oreo
(1 Subdivision (comptete 10))

boxes)

C Dividing land into parts by agreement (complete 11))

  

 

[1 Boundary realignment (complete 12))

 

 

( Creating or changing an easement giving access to a lot
from a constructed road (complete 73)

 

 

10) Subdivision
10.1) For th

 

Intended use of lots created

Residential

Commercial Industrial

 

development, how many lots are being created and what is the intended use of those lots:

Other, please specify:

 

 

Number of lots created

CINo

LD Yes — provide additional details below

 

 

How many stages will the works include?

 

 

apply to?

What stage(s) will this development application

 

 

 

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DA Form 1 — Development application details

Version 1,.3— 28 September 2020

Page 7

11) Dividing land into parts — how many parts are being created and what is the intended t

eclacre
Intended use of parts created Residential Commercial Industrial Other, please specify:

 

 

 

 

 

 

 

Number of parts created

 

 

Current lot Proposed lot
Lot on plan description Area (m?) Lot on plan description Area (m?)

 

 

 

 

 

 

 

 

 

13) What are the dimensions and nature of any existing easements being changed and/or any proposed easement?

(attach mea: ore than two easements)

Existing or Width (m) | Length (m) | Purpose of the easement? (e.g. Identify the land/lot(s)
proposed? pedestrian access) benefitted by the easement

 

 

 

 

 

 

 

 

 

 

Division 3 — Operational work

Note: This division is only required to be completed if any part of the development application involves operational work,
14.1) What is the nature of the operational work?
CO Road work CO Stormwater 00 Water infrastructure
Ld Drainage work (7 Earthworks ( Sewage infrastructure
(1 Landscaping OO Signage (1 Clearing vegetation
[xX] Other — please specify: Habitat restoration / enhancement.
14.2) Is the operational work necessary to facilitate the creation of new lots? (e.g. subdivision)
LD Yes — specify number of new lots:
J No
14.3) What is the monetary value of the proposed operational work? (include GST. and labour)
Estimate $500,000

 

 

 

 

PART 4 —- ASSESSMENT MANAGER DETAILS

15) Identify the assessment manager(s) who will be assessing this development application
Noosa Shire Council

 

16) Has the local government agreed to apply a superseded planning scheme for this development application?

CO Yes — a copy of the decision notice is attached to this development application

C1 The local government is taken to have agreed to the superseded planning scheme request — relevant documents
attached

I No

 

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DA Form 1 — Development application details
Version 1.3— 28 September 2020

Page 8

PART 5 — REFERRAL DETAILS

 
   

   

17) Does thi velopment application include any aspects that have any referral requirements?
Note: A a lanning 017.

 

CI No, there are no referral requirements relevant to any development aspects identified in this development
application — proceed to Part 6

Matters requiring referral to the Chief Executive of the Planning Act 2016:

OD Clearing native vegetation

(1 Contaminated land (unexploded ordnance)

LO Environmentally relevant activities (ERA) (only if the ERA has not been devolved to a local government}

(1 Fisheries — aquaculture

] Fisheries — declared fish habitat area

J Fisheries - marine plants

LC Fisheries — waterway barrier works

LC Hazardous chemical facilities

(7) Heritage places — Queensland heritage place (on or near a Queensland heritage place)

(CJ Infrastructure-related referrals — designated premises

CL Infrastructure-related referrals — state transport infrastructure

(J Infrastructure-related referrals — State transport corridor and future State transport corridor

(1 Infrastructure-related referrals — State-controlled transport tunnels and future state-controlled transport tunnels

(J Infrastructure-related referrals — near a state-controlled road intersection

LD Koala habitat in SEQ region — interfering with koala habitat in koala habitat areas outside koala priority areas

C1 Koala habitat in SEQ region — key resource areas

C Ports — Brisbane core port land — near a State transport corridor or future State transport corridor

O Ports — Brisbane core port land - environmentally relevant activity (ERA)

LC] Ports — Brisbane core port land — tidal works or work in a coastal management district

C1 Ports — Brisbane core port land — hazardous chemical facility

(J Ports — Brisbane core port land — taking or interfering with water

( Ports — Brisbane core port land — referable dams

LC Ports — Brisbane core port land — fisheries

C1 Ports — Land within Port of Brisbane's port limits (below high-water mark)

CD SEQ development area

(1 SEQ regional landscape and rural production area or SEQ rural living area — tourist activity or sport and
recreation activity

(1 SEQ regional landscape and rural production area or SEQ rural living area — community activity
(1 SEQ regional landscape and rural production area or SEQ rural living area — indoor recreation
CO SEQ regional landscape and rural production area or SEQ rural living area — urban activity

(1 SEQ regional landscape and rural production area or SEQ rural living area — combined use
Tidal works or works in a coastal management district

LD Reconfiguring a lot in a coastal management district or for a canal

EX] Erosion prone area in a coastal management district

CO Urban design

LC Water-related development — taking or interfering with water

CL Water-related development — removing quarry material (from a watercourse or lake)

LO Water-related development — referable dams

(] Water-related development —levees (category 3 levees only)

KX] Wetland protection area

Matters requiring referral to the local government:
OD Airport land
C1 Environmentally relevant activities (ERA) (only if the ERA has been devolved to local government)

 

 

 

 

 

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DA Form 1 — Development application details
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Page 9

LJ Heritage places — Local heritage places

Matters requiring referral to the Chief Executive of the distribution entity or transmission entity:
(1 infrastructure-related referrals — Electricity infrastructure

 

 

Matters requiring referral to:

e The Chief Executive of the holder of the licence, if not an individual

e The holder of the licence, if the holder of the licence is an individual

(1 Infrastructure-related referrals — Oil and gas infrastructure

Matters requiring referral to the Brisbane City Council:

LC Ports — Brisbane core port land

Matters requiring referral to the Minister responsible for administering the Transport Infrastructure Act 1994:
(Ports ~ Brisbane core port land (where inconsistent with the Brisbane port LUP for transport reasons)
CJ Ports — Strategic port land

Matters requiring referral to the relevant port operator, if applicant is not port operator:
C Ports — Land within Port of Brisbane's port limits (below high-water mark)

 

 

 

 

Matters requiring referral to the Chief Executive of the relevant port authority:
CJ Ports — Land within limits of another port (below high-water mark)

 

Matters requiring referral to the Gold Coast Waterways Authority:
O Tidal works or work in a coastal management district (in Gold Coast waters)

 

Matters requiring referral to the Queensland Fire and Emergency Service:
U1 Tidal works or work in a coastal management district (involving a marina (more than six vessel berths))

 

 

18) Has any referral agency provided a referral response for development application?
(1 Yes — referral response(s) received and listed below are attached to this development application

KI No

 

Referral requirement Referral agency Date of referral response

 

 

 

 

 

Identify and describe any changes made to the proposed development application that was the subject of the

referral response and this development application, or include details in a schedule to this development application
(if applicable}.

 

 

 

PART 6 — INFORMATION REQUEST

  
   
         
     
     

  

19) Information request under Part 3 of the DA Rules

EX] | agree to receive an information request if determined necessary for this development application
(1 Ido not agree to accept an information request for this development application
Note: By not agreeing to accept an information request |, the applicant, acknowledge:

¢ that this development application will be assessed and decided based on the information provided when making this development
application and the assessment manager and any referral agencies relevant to the development application are not obligated under the DA
Rules to accept any additional information provided by the applicant for the development application unless agreed to by the relevant
parties
« Part 3 of the DA Rules will still apply if the application is an application listed under section 11.3 of the DA Rules.
Further advice about information requests is contained in the DA Forms Guide.

         

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DA Form 1 — Development application details
Version 1.3— 28 September 2020

Page 10

PART 7 — FURTHER DETAILS

 

20) Are there any associated development applications or current approvals? (e.<
LO Yes — provide details below or include details in a schedule to this development application

I] No

 

List of approval/development Reference number Date Assessment
application references manager

LO Approval
C1 Development application

CD Approval
LJ Development application

 

 

 

 

 

 

 
   

fonal work)

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

EX] No — |, 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

C1 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 (A, B or E)

 

 

 

 

 

 

evelopment application in response to a show ca 8 required as a result of an enforcement

 

LJ Yes — show cause or enforcement notice is attached
No

 

23) Further legislative r

Environmentally relevant activities

23.1) Is this development application also taken to be an application for an environmental authority for an

Environmentally Relevant Activity (ERA) under section 115 of the Environmental Protection Act 1994?

U1 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.aid.gov.au. An ERA
requires an environmental authority to operate. See www.business.q/d.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.

Hazardous chemical facilities

 

 

 

 

23.2) Is this development application for a hazardous chemical facility?

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.g/d.gov.au for further information about hazardous chemical notifications.

 

 

 

 

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DA Form 1 — Development application details
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Page 11

Clearing native vegetation

5 firmation that
ief executive of the V tation Management Act 1999 is satisfied the clearing is for a relevant purpose under
‘A of the Vegetation Management Act

(7 Yes — this development application includes written confirmation from the chief executive of the Vegetation
Management Act 1999 (s22A determination)

KI No

Note: 7. 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 hifps:/Awww.gid.gov.au/environment/land/vegetation/applying for further information on how to obtain a s22A determination.

Environmental offsets

23.4) Is this development application taken to be a prescribed activity that may have a significant residual impact on
a prescribed environmental matter under the Environme Offsets Act 2014?

LO Yes —1 acknowledge that an environmental offset must be provided for any prescribed activity assessed as
having a significant residual impact on a prescribed environmental matter

KI No

Note: The environmental offset section of the Queensland Government's website can be accessed at www.qid.gov.au for further information on
environmental offsets.

Koala habitat in SEQ Reg
5) Does this development application involve a material change of use, reconfiguring a lot or operational work
elena toys le development under Schedule 10, Part 10 of the Planning Regulation 2017?
C1 Yes — the development application involves premises in the koala habitat area in the koala priority area
LO Yes — the development application involves premises in the koala habitat area outside the koala priority area

KI No

Note: if a koala habitat area determination has been obtained for this premises and is current over the land, it should be provided as part of this
development application. See koala habitat area guidance materials at www.des.gld.gov.au for further information.

A Fecha eee Ree)

23.6) Does this development application involve taking or interfering with underground water through an
artesian or subartesian bore, taking or interfering with water in a watercourse, lake or spring, or taking
overland flow water under the Water Act 2000?

LO Yes — the relevant template is completed and attached to this development application and | acknowledge that a
relevant authorisation or licence under the Water Act 2000 may be required prior to commencing development

KI No

Note: Contact the Department of Natural Resources, Mines and Energy at www.dnrm:

 

 

jov.au for further information.

 

DA templates are available from hitps://planning.dsdmip.qid.gov.au/. If the development application involves:

* — Taking or interfering with underground water through an artesian or subartesian bore: complete DA Form 1 Template 1
* Taking or interfering with water in @ watercourse, lake or spring: complete DA Form? Template 2

¢ Taking overland flow water: complete DA Form 1 Template 3.

ENT EW Medela a (tm eld)

3.7) Does this application involve waterway barrier works?
(1 Yes — the relevant template is completed and attached to this development application
No

DA templates are available from htips://planning.dsdmip.gid.gov.au/, For a development application involving waterway barrier works, complete
DA Form 1 Template 4.

    
    

Marine activities

3.8) Does this development application involve aquaculture, works within a declared fish habitat area or
removal, disturbance or destruction of marine plants?

Xx] Yes — an associated resource allocation authority is attached to this development application, if required under
the Fisheries Act 1994

LINo

Note: See guidance materials at www.daf.a/d_gov. au for further information.

 

 

 

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Page 12

Quarry materials from_a watercourse or lake

3.9) Does this opment application involve the removal of quarry materials from a watercourse or lake
under the Water Act 2000:

(1 Yes — | acknowledge that a quarry material allocation notice must be obtained prior to commencing development
& No
information.

Quarry materials from land under tidal waters

 

23.10} Does this development application involve the removal of quarry materials from land under tidal water
sr the Coastal Protection and Management Act

 

U0 Yes — | acknowledge that a quarry material allocation notice must be obtained prior to commencing development
{KI No

Note: Contact the Department of Environment and Science at www.des.g/d.gov.au for further information.

    
    
 
       

Referable dams

C1 Yes — the ‘Notice Roce a Failure se Assessment’ from the chief executive ‘administering the Water
Supply Act is attached to this development application

I] No

Note: See guidance materials at www.dnrme.gid.gov.au for further information.
Tidal work or development within a coastal management district
23.12) Does this development application involve tidal work or development in a coastal management district?

KI Yes — the following is included with this development application:

[Evidence the proposal meets the code for assessable development that is prescribed tidal work (only required
if application involves prescribed tidal work)

(1 Acertificate of title
CINo

Note: See guidance materials at www.de: ov.au for further information.
Queensland and local heritage places

 

 

23.13) Does this development application propose development on or adjoining a place entered in the Queensland
heritage register or on a place entered in a local government's Local Heritage Register?

L Yes — details of the heritage place are provided in the table below
KI No

Note: See guidance materials at www.des.gid.gov.au for information requirements regarding development of Queensiand heritage places.
Name of the heritage place: Place ID:

 

 

 

Brothels

23.14) Does this development application involve a material change of use for a brothel?

C1 Yes — this development application demonstrates how the proposal meets the code for a development
application for a brothel under Schedule 3 of the Prostitution Regulation 2014

KI No

Decision under section 62 of the Transport Infrastructure Act 1994

 

23.15) Does this development ap tion involve new or changed access to a state-controlled road?

(1 Yes — this application will be taken to be an application for a decision under section 62 of the Transport
Infrastructure Act 1994 (subject to the conditions in section 75 of the Transport Infrastructure Act 1994 being
satisfied)

KI No

 

 

 

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DA Form 7 — Development application details
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Page 13

Walkable neighbourhoods assessment benchmarks under Schedule 12A of the Planning Regulation

3.16) Does this develo ation involve reconfiguring a lot into 2 or more lots in certain residential zones
pt rural residential Kom (x) @elalom cex-\e| ited or extended?
LO Yes — Schedule 12A is applicable to the development application and the assessment benchmarks contained in
schedule 12A have been considered
No
Note: See guidance materials at www.planning.dsdmip.qid.gov.au for further information.

 

PART 8 — CHECKLIST AND APPLICANT DECLARATION

 

24) Development application checklist

! have identified the assessment manager in question 15 and all relevant referral
requirement(s) in question 17 KI Yes
Note: See the Planning Regulation 2017 for referral requirements

If building work is associated with the proposed development, Parts 4 to 6 of DA Form 2— [Yes
Building work details have been completed and attached to this development application I Not applicable

 

 

Supporting information addressing any applicable assessment benchmarks is with the

development application

Note: This is a mandatory requirement and includes any relevant templates under question 23, a planning report XN Yes
and any technical reports required by the relevant categorising instruments (e.g. local government planning

schemes, State Planning Policy, State Development Assessment Provisions). For further information, see DA

Forms Guide: Planning Report Template.

Relevant plans of the development are attached to this development application

Note: Relevant plans are required to be submitted for all aspects of this development application. For further Xi Yes
information, see DA Forms Guide: Relevant plans.

The portable long service leave levy for QLeave has been paid, or will be paid before a KX] Yes
development permit is issued (see 21) (Not applicable

25) Applicant declaration

[Xd] By making this development application, | declare that all information in this development application is true and
correct

Where an email address is provided in Part 1 of this form, | consent to receive future electronic communications
from the assessment manager and any referral agency for the development application where written information
is required or permitted pursuant to sections 11 and 12 of the Electronic Transactions Act 2001

Note: it is unlawful to intentionally provide false or misleading information.

Privacy — Personal information collected in this form will be used by the assessment manager and/or chosen

assessment manager, any relevant referral agency and/or building certifier (including any professional advisers

which may be engaged by those entities) while processing, assessing and deciding the development application.

All information relating to this development application may be available for inspection and purchase, and/or

published on the assessment manager's and/or referral agency's website.

Personal information will not be disclosed for a purpose unrelated to the Planning Act 2076, Planning

Regulation 2017 and the DA Rules except where:

e such disclosure is in accordance with the provisions about public access to documents contained in the Planning
Act 2016 and the Planning Regulation 2017, and the access rules made under the Planning Act 2016 and
Planning Regulation 2017; or

e required by other legislation (including the Right to Information Act 2009); or

e otherwise required by law.

This information may be stored in relevant databases. The information collected will be retained as required by the

Public Records Act 2002.

 

 

 

 

 

 

 

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Page 14

PART 9 —- FOR COMPLETION OF THE ASSESSMENT MANAGER -— FOR OFFICE

USE ONLY

 

Date received: [i] Reference number(s): [

 

 

Notification of engagement of alternative assessment manager

Prescribed assessment manager

 

Name of chosen assessment manager

 

Date chosen assessment manager engaged

 

Contact number of chosen assessment manager

 

Relevant licence number(s) of chosen assessment
manager

 

(Nelo SS

Description of the work

 
   

 

QLeave project number

 

Amount paid ($)

Date paid (dd/mm/yy)

 

Date receipted form sighted by assessment manager

 

 

Name of officer who sighted the form

 

 

 

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DA Form 1 — Development application details
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Page 15

SCHEDULE 1 - RELEVANT LOTS

Application is for USL adjacent to the following Lots

 

 

 

 

 

 

 

 

 

 

 

 

 

Restoration Lot EL Street Address Tenure
Site
Goat Island Conservation Park .
Goat Island | 35 | MCH4795 Noosa North Shore QLD 4565 National Park
Tewantin 326 | CP855842 9 Pelican Street, Tewantin QLD 4565 Reserve
Noosa Sound | 604 | SP188270 1B Serenity Close, Noosa Heads QLD Freehold
West 4567
Petrie Mansions
0 | $P103385 | serenity Close, Noosa Heads QLD 4567 | Freehold
Macquarie Lodge
Q | BUP13469 Serenity Close, Noosa Heads QLD 4567 Freehold
Banksia Avenue Noosa Heads QLD 4567 a
Reserve
{ RP92804 1 Natasha ae Heads QLD Freehold
7 RP107007 3 Natasha Avenue, Noosa Heads QLD Freehold
Noosa Sound Allunga Mia
East 0 BUP2048 Natasha Avenue, Noosa Heads QLD 4567 Freehold
5 | SP234718 | Natasha Avenue, Noosa Heads QLD 4567 Freehold
3 RP106422 11 Natasha — moe Heads QLD Freehold
2 RP106442 13 Natasha Avenve Noosa Heads QLD Freehold
{ RP97493 15 Natasha ae a Heads QLD Freehold
Noosa Crest
0 BUP8432 Natasha Avenue, Noosa Heads QLD 4567 Freehold

 

 

 

 

 

 

Local
Government

Noosa Shire