Operational Works Application OPW21/0243 - Driveway application and supporting documents - 6 Robin Place, Lake MacDonald

       Where an email address is provided in Part 1 of this form, I 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 infomnation 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 2016, Planning
       Regulation 2017 and the DA Rules except where:
       • 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
       • required by other legislation (including the Right to Information Act 2009)] or
       • 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.


PART 9 - FOR OFFICE USE ONLY

        Date receivecReference number(s):




        Prescribed assessment manager

        Name of chosen assessment manager
        Date chosen assessment manager engaged
       Contact number of chosen assessment manager

       Relevant licence numbers) of chosen assessment
       manager




        Description of the work

       QLeave project number
       Amount paid ($)
        Date paid
        Date receipted form sighted by assessment manager

       Name of officer who sighted the form




                                                                                               Queensland
                                                                                               Government