08/0853 - Operational Works - Landscaping [As Published] · 142008.853

INTEGRATED PLANNING ACT 1997 Part A, Version 3.1, 3 March 2008

Attachments and supporting information (Complete Table | - Use a separate row for each type of attachment or information, including information required under
this Part) Please ensure all documentation submitted with this form, inckding other Parts of Form 1, or owner's consent, etc, are securely attached to this Part of the Form.

 

 

 

 

 

 

 

Description of attachment or information thes -
Table | i Title (if appicable) Method of delivery to
(19 Pat C of Form 1 owner consent evidence SOUT? | (esa Genert Athodty,Jomes Stree Trae Repo) Date assessment manager
' SEE AVACHeED cust ovee THE
“4 OUNTEL

eve. on | sevon Co¥ |acvor 6O\| SCVO2 604 cou

Kevo2 co2| Scvor 008 lecvou Go2 |Scvoad bO0S

Sevo2r cos| SevOr Nl VOX FOR

t f

 

 

1
Portable Long Service Leave (PLSL) levy (Applicable for certain building and construction work valued over $80,000 only)

10. The Portable Long Service Leave Levy (PLSL) is not applicable to this application if any of the following apply: (~ box if applicable)
the application seeks a preliminary approvat only;

7 the application is not for building and construction work under the Building and Construction Industry (Portable Long Service Leave)

Act 1991, section 3AA (e.g. the application is only for a change of use, or for the following types of work carried out solely for farming purposes:
fand clearing, site preparation, earthworks, fences, fodder harvesting, clearing of encroaching vegetation, clearing of regrowth, thinning vegetation or
controlling weeds or pests);

(Call costs, that relate to the work both directly and indirectly, are less than $80,000, inclusive of GST; or

e@ CU the work is being carried out under an owner-builder permit issued under the Queensland Building Services Authority Act 1991 -
Complete and submit a QLeave Nofification and Payment Form (no payment required if owner-builder permil number stated). The receipted form must be sighted by the
assessment manager before a development permit can be given.

11. Is payment of a PLSL levy applicable to this application? (Refer to Q10 and the Advice below for more information)
No - End of Part A (5 res - Answer Q12 below ( To be indoded in Building Applicat )

12. Has the PLSL levy been paid?
O No - (NOTE: An application can be todged prior to payment of the applicable PLSL levy. However, the levy must be paid and the receipted form sighted by the

Assessment Manager before a development permit may be given for this application. To pay the levy you will need to complete and submit a Notification
and Payment Form to QLeave,)

Oo Yes - Complete Table L and submit, with the application, the ‘yellow’ (Local Government's (Council) / Private Certifier's) copy of the receipted QLeave Form.

, - QLeave Project Number
Table L Amount paid Date paid (6 cigits, starting with A, B. E, L or P}

 

 

 

 

 

 

 

 

 

OFFICE USE ONLY (For use by the Assessment Manager / Private Certifier) (Optional)

' ; . Receiving ” Reference
e@ Fee (8) | [toSo Date received is) 3 [os officer's name br, Gon numbers | © ¢/ S54
\ 7
NOTIFICATION OF ENGAGEMENT OF PRIVATE CERTIFIER

 

 

 

 

 

 

 

 

 

 

To:

 

 

Council. | have been engaged as the private certifier for the building work referred to in this application.

 

 

Date of engagement Name BSA Certification license number Buitding ctassification/s

 

 

 

 

 

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

 

Amount paid Date receipted form
“rv Oteave Project Number ($) Date paid sighted by Name of officer who sighted the form
assessment manager

 

 

 

 

 

 

 

 

 

Privacy Statement

The information collacted on Form 1 will be used by the Department of infrastructure and Planning (DIP) in accordance with the processing and assessment of your Application.
Your personal details will not be disclosed for a purpose outside of the IDAS process, except where required by lagisiation (including the Freedom of information Act 1992) or
a required by Parliament, This information may be stored in a DIP database. The information collected will be retained as required by the Public Records Act 2002

 

 

 

Page 3