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

QLEAVE NOTIFICATION AND PAYMENT (for completion by assessment manager or private certifier if applicable)


                                                                               Date receipted
                                      QLeave Project    Amount                 form sighted by Name of officer who
              Description of the work                              Date paid
                                      Number            paid ($)               assessment      sighted the form
                                                                               manager


        1


The Sustainable Planning Act 2009 (SPA) is administered by the Department of Infrastructure and Planning. This
form and all other required application materials should be sent to your assessment manager and any referral
agencies.




                                                                                      AppIicarion Detain - IDAS form 1
                                                                                        Version 1.0 18 December 2009