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10/0366 - Op Works - Jetty [As Published] · 142010.366
LiL
QLEAVE NOTIFICATION AND PAYMENT (for completion by assessment manager or private certifier if applicable)
Date receipted
a QLeave Project [Amount ., {form sighted by|Name of officer who
Description of the work Number paid ($) Date paid assessment sighted the form
manager
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.
Application Details - IDAS form 1
Version 1.0 18 December 2009
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