Development Application part 1 of 2 IDAS Form 1 & 5 MCU11/0178

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


q No ® Yes - ensure the nature, location and dimensions of proposed works are included in plans submitted


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


® No - Go to question 15                   q Yes



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 Has the local government agreed to apply a superseded planning scheme to this application under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



® No
q    Yes - provide details below



16. List be low all of the forms and supporting information that accompany this application (include all IDAS
forms, che( :klists, mandatory supporting information etc. that will be submitted as part of this application. Note: this
question do yes not apply for applications made online using Smart eDA)

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

            1    Town Planning Report                                                            mail



            2    Plans                                                                           mail


            3    Was Forms                                                                       mail



17. Applicant's declaration


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




                                                                                            Application Deta.,is - IDAS form I
                                                                                              Version 1.0 18 December 2009