00154413.001

INTEGRATED PLANNING ACT 1997                                                                           IDAS Assessment Checklist, Version 20, 2 April2007*
 Contaminated land                       17.  The application involves: (tick the applicable box/es)
 Applications Involving material change of use     i                               i                         i        -
 anal or feoonfguting@ lot may bigger ths      C5 (i) reconfiguring alot for which all of part of the premises are
referral,                                               (a)  premises mentioned in the IPA, schedule 8, part 1, table 2 -
 For more information refer to Guide 5.                    * item 5, including the exemption otherwise provided for by paragraph (d);
 Unless you answered “none of the above" to                « item 6, including the exemption otherwise provided for by paragraph (e); or
 Q17, the application requires assessment by the           * item 7, including the exemption otherwise provided for a mining activity or petroleum
 Environmental Protection Agency (EPA). if an                  ctivity:
 agency other than EPA is the assessment                      a  Mity; oF      .                              .              .
 manager for the application, EPA will be a             (b)   in an area for which an area management advice has been given for unexploded
 concurrence agency for the application in                    ordnance - complete Part N of Form 1
 felation to this matter.                          .            .
                                               (J (ii) a material change of use -
                                                        (a)   made assessable under the IPA, schedule 8, part 1, table 2, items 5 to 7; or
                                                        (b)  assessable against the planning scheme and if all or part of the premises is in an area
                                                              for which an area management advice has been given for unexploded ordnance -
                                                              completa Part N of Form 1
                                               (X1 (iii) none of the above
 Electricity infrastructure               18.  The application involves: (tick the applicable boxes)
 For more information refer to schedule 2of the IF LJ {i) reconfiguring a lot where any part of the lot is -
 U        ;        .              :                     * subject to an easement in favour of a distribution entity or transmission entity under the
  nless you answered “none of the above" to                      a                               .              wo      :
 Q18, the application triggers referral to the            Electricity Act 1994 and the easement is for a transmission grid or supply network under
 agency to which the easement Is granted in                that Act; or
 favour of as advice agency.                            * situated within 100m of a substation site;                                                ©
                                               [_] (ii) a material change of use, assessable against a planning scheme and not associated
                                                        with reconfiguring a lot if -
                                                        ¢ any part of the premises is subject to an easement in favour of a distribution entity or
                                                           transmission entity under the Electricity Act 1994 and the easement is for a transmission
                                                           grid or supply network under that Act; and
                                                        * any structure or work that is the natural and ordinary consequence of the use is, or will be,
                                                           located wholly or partly in the easement;
                                               C1 (iii) a material change of use, assessable against a planning scheme and not associated
                                                        with reconfiguring a lot if any part of the premises is situated within 100m of a substation
                                                        site;
                                               (1 (iv) operational work that is filling or excavation assessable against the planning scheme,
                                                        not associated with reconfiguring a lot, if -
                                                        * any part of the premises is subject to an easement in favour of a distribution entity or
                                                           transmission entity under the Electricity Act 1994 and the work is located wholly or partly in
                                                           the easement;
                                                        e the work is located wholly or partly within 10m of a substation site;
                                               EX] (v)  none of the above.
 Land designated for community            19.  Does the application involve development assessable against the planning scheme and on ng
 infrastructure                                designated for community infrastructure?
 Applications Involving development on land     yt                        ;            ;            i
 designated for community Infrastructure may   (i)  intended to be supplied by a public sector entity; and
 trigger this referral.                        (ii) on land not owned by or on behalf of the State; and
 For more information refer to schedule 2 of the (iii) other than development -
 IP Regutation.
 tf you answered “YES” to Q19, the application     (a)   for the designated purpose; or
 requires assessment by the chief executive of               :                                 ‘
 the department administering the Act authorsing   (b)   carried out by, or on behalf of, the designator.
 the development for the designated purpose.    —X] No
 If an agency other than the designator is the
 assessment manager for the application, the    O YES
 designating agency will be a concurrence
 agency for the application in relation to this
 matter.

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