22SeahorsePlace · OPW18/0054

                                                                                 De pa         t of lnfrastructure, LocaI Government and Ptannir


Note: See the Planning Regulation 201 7 for referral requirements

lf building work is associated with the proposed development, Parts 4                          6of          Eyes
Form 2 - Building work details have been completed and attached to
development application                                                                                     EI Not applicable
Supporting information addressing any applicable assessment ben                                ; is with
development application
Note: This is a mandatory requirement and includes any relevant templates under                2.3,   a.    E yes
planning report and any technical reports required by the relevant categorising i)
government planning schemes, State Planning Policy, State Development Assessment
furcher information, see DA Forms Guide: Planning Reoort Template.
Relevant plans of the development are attached to this development
Note: Relevant plans are required to be submitted for all aspects of this development          ation.   For E Yes
further information, see DA Forms Guide: Relevant plans.
The portable long service leave levy for Qleave has been paid, or will                     paid before n Yes
a development permit is issued Gee 21))                                                                     $
                                                                                                         trlot applicable

25) Applicant declaration
E|'SV making this development application, I declare that all informat                     in this development application is
true and correct
EfWhere an email address is provided in Part 1 of this form, I c                            receive future electronic
communications from the assessment manager and any referral a                             for the development application
where written information is required or permitted pursuant to sectio                      11 and 12 of l.he Electronic
Transactions Act 2007
Note: lt is unlawful to intentionally provide false or misleading information.
           -
Privacy Personal                                                                               assessment manager and/or
chosen assessment manager, any relevant referral agency andlor bui                              certifier (including any professional
advisers which may be engaged by those entities) while processing,                              ing and deciding the development
application.
All information relating to this development application may be                            for inspection and purchase, and/or
published on the assessment manager's andlor referral agency's                           .e.
Personal information will not be disclosed for a purpose unrela                          to the Planning Act 2016, Planning
Regulation ?O17 and the DA Rules except where:
. such disclosure is in accordance with the provisions about                                    ss to documents contained in the
    Planning Act 201 6 and the Planning Regulation 2017, and the                                rules made under the Planning Act
    201 6 and Planning Regulation ?017; or
. required by other legislation (including lhe Right to lnformation A                    2009); or
. otherwise required by law.
This information may be stored in relevant databases. The informa                        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

Name of chosen assessment manager
Date chosen assessment manager engaged
                                                                                                                                 Page 1 'l
                                                                                                DA Form - Development
                                                                                                       1              Application details
                                                                                                               Version 1.O-3 July 2O17