OPW14/0307 - Application for Prescribed Tidal Works

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     Question 12
     • The portable long service Ieave levy need not be paid when the application is made, but the Building and
        Construction Industry (Po rtable Long Service Leave) Act 1991 requires the levy to be paid before a development
       permit is issued.
     • Building and construction industry notification and payment forms are available from any Queensland post office or
       agency, on request from QLeave, or can be completed on the QLeave website at www.qleave.qld.gov.au.         For
       further information contact QLeave on 1800803481 or visit www.qleave.qld.gov.au.


    Privacy-The    information col lected in this form will be used by the Department of State Development, Infrastructure
    and Planning (DSDIP), asses sment manager, referral agency and/or building certifier in accordance with the
    processing and assessment of your application. Your personal details should not be disclosed for a purpose outside of
    the IDAS process or the provi sions about public access to planning and development information in the Sustainable
    Planning Act 2009, except wh ere required by legislation (including the Right to Information Act 2009) or as required by
    Parliament. This information may be stored in relevant databases. The information collected will be retained as
    required by the Public Recor ds Act 2002.


     OFFICE USE ONLY

      Date received
                          I                                        I Reference numbers
     NOTIFICATION       OF ENGAG EMENT OF A PRIVATE CERTIFIER

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

                                                                                     BSA Certification license          Building
      Date of engagement           Nam e
                                                                                     number                             classification/s




    QLEAVE NOTIFICATION             AN D PAYMENT (For completion              by assessment     manager or private certifier     if
    applicable.)

                                                                                                      Date receipted
                                                                                                                          Name of officer
                                           QLeave project          Amount paid                        form sighted by
      Description of the work                                                           Date paid                         who sighted the
                                           number                  ($)                                assessment
                                                                                                                          form
                                                                                                      mana er




    The Sustainable Planning Act 2009 is administered by the Department of State Development, Infrastructure and
    Planning. This form and all other required application materials should be sent to your assessment manager and any
    referral agency.




lapartment of State Development,   Infrastructure   and Planning
'0 Box 15009 City East Qld 4002
,113 QGOV (13 74 68)
[email protected],au
                                                                                                              IDAS form I-Application details
lWW.dsdip.qld.gov.au                                                                                                 VersioIl3.D-I July 2013