DAForm1-Developmentapplicationdetails (1)

24) Development application checklist
I have identified the assessment manager in question 15 and all relevant referral
requirement(s) in question 17                                                                                           Yes
Note: See the Planning Regulation 2017 for referral requirements
If building work is associated with the proposed development, Parts 4 to 6 of DA Form 2 –                               Yes
Building work details have been completed and attached to this development application                                  Not applicable
Supporting information addressing any applicable assessment benchmarks is with
development application
Note: This is a mandatory requirement and includes any relevant templates under question 23, a planning report          Yes
and any technical reports required by the relevant categorising instruments (e.g. local government planning
schemes, State Planning Policy, State Development Assessment Provisions). For further information, see DA
Forms Guide: Planning Report Template.
Relevant plans of the development are attached to this development application
Note: Relevant plans are required to be submitted for all aspects of this development application. For further          Yes
information, see DA Forms Guide: Relevant plans.
The portable long service leave levy for QLeave has been paid, or will be paid before a                                 Yes
development permit is issued (see 21))                                                                                  Not applicable

25) Applicant declaration
   By making this development application, I declare that all information in this development application is true and
correct
   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 information 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 received:                                         Reference number(s):

Notification of engagement of alternative assessment manager
Prescribed assessment manager
Name of chosen assessment manager
Date chosen assessment manager engaged
Contact number of chosen assessment manager
Relevant licence number(s) of chosen assessment
manager




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                                                                                                        DA Form 1 – Development Application details
                                                                                                                      Version 1.1— 22 JUNE 2018