Development Application part 1 of 2 - Application forms MCU12/0066

12. Does the proposal include new building work or operational work on the premises? (including
                                                                                                                        any
      services)

oNo rgJ Yes          -
                         ensure the nature, location and dimensions of      proposed works are included in plans submitted

13. Is the payment ofa portble long service leave levy applicable to this application? (refer to the notes at the
      end of this form for more information)


rgJ No   -
             Go to question 15                    DYes


15. Has the local government agreed to apply a supers ded planning scheme to this
                                                                                                          application under
      section 96 of the Sustainable Planning Act 2009?



rgJ    No

DYes provide details below
             -




16. List below all ofthe
                          f~rl1!s and supporting information,,,that accompany this applicatior (include alllDAS
forms, checklists, mandatory}~upporting information etc. that .xiII be submitted as part of this applcation. Note: this
question does not apply for applications made online using Smart eDA)

                                                                                                           Method of lodgement to
                                   Description of attachment or title of attachment
                                                                                                            assessment manager


                 1   IDAS forms and checklist, plans, title & SP etc                                       over the counter




117. Applicant’s declartion                      >,? ~    ~w:
                                                            k’              "Iii




                         this
 ~ By making       application,            I declare that all information in this application is true and correct (note: it is
   unlawful to provide false    misleading information).
                                      or




                                                                                                      Application Details   -
                                                                                                                                IDAS form 1
                                                                                                         Version 1.0 18 December 2009