180093 - DA Form 2

This development application includes a material change of use, reconfiguring a lot or
operational work and is accompanied by a completed Form 1 – Development
                                                                                                                 ☐ Yes
application details                                                                                              ☑ Not applicable
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
                                                                                        ☐ Not applicable

20) 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 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 7 – FOR OFFICE USE ONLY - FOR COMPLETION BY THE ASSESSMENT
MANAGER

Additional building details required for the Australian Bureau of Statistics
Existing building use/classification? (if applicable)                            6
New building use/classification?                                                 6
Site area (m2)                                                                   Floor area (m2)                     Approx 45 m2 proposed


Additional information required by the local government
Confirm proposed construction materials:

                                           ☐ Double brick                        ☐ Steel                             ☐ Curtain glass
External walls                             ☐ Brick veneer                        ☐ Timber                            ☐ Aluminium
                                           ☑ Stone/concrete                      ☐ Fibre cement                      ☐ Other
                                           ☐ Timber                              ☑ Steel                             ☐ Aluminium
Frame
                                           ☐ Other

                                                                                                                                              Page 6
                                                                                                           DA Form 2 – Development Application details
                                                                                                                             Version 1.0—3 July 2017