07/1409 - MCU - Domestic Marine [As Published] · 142007.1409

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INTEGRATED PLANNING ACT 1997 Part A, Version 2.4, 29 May 2006
Land owner's consent (if applicable) 20. Land owner's consent to the making of this application:
Section 3.2.1(3) of the IPA prescribes that an Name Date

application mest contain, or be supported by, the
vwritien consent of the land owner/s, i the application
involves:

@) a material change of use;

@ reconfiguration of a lot;

Shynatufh /]

 

 

 

 

 

 

 

 

(@) work on land below high-water mark & not within a (i)
canal as defined under the Coastal Protection andy eee cee bene e eee cee cee cee ee ee ee eee ee pene eee eee eee
Management Act 1995:0r hee
@) work on rail corridor land defined under the (iii)
Transport infrastructure Act 1998 eee cee bocce eee cece eee eee ce cece eee enc ees feceereeeeeeee
Section 3.8.1(2)(a) of the IPA provides that .
tandowner’s consent is nog required for a mobile or (iv)
temporary ERA nnn nn nn rere corn ren ern enn arene cc cnec Ponsa ttstes sects cesses steescorsresperscnssccnees
For more information refer to Guide 1, )
Resource entitlement (if applicable) 21. Does this application involve a State resource prescribed under a regulation (other than involving
Section 3.2.1(5) of the IPA requires evidence of quarry jnaterial on State coastal land under the Coastal Protection and Management Act 1995)?
resource entitlement be given for applications that
Involve a prescribed State resource. NO - go to. Q24 (1) YES- goto a22
Section 3.2.1(10}(a)(i) of the IPA prescribes that . opt: . A
application ceorat eaten to be property me 22. This application is accompanied by evidence: (tick applicable box)

without evidence of the resource entitlement.

Advice for completing Q21 & 22

Refer to schedule 10 of the integrated Planning
Reguiation 1998 that prescribes the nature of evidence
tequired by the State in support of the lodging of this
development application.

Advice for compteting Q23

The information to (1) - (v) is mandatory if evidence Is
required under Q22 (il) or (ik) above.

The official stamp of the Department of Natural
Resources, Mines and Water is mandatory where the
application involves any water or riverine quarry
material under the Water Act 2000.

Section 3.2.1(5A) allows the resource manager to Emit
the time the evidence may be used. 023 (vi) must be
completed if the evidence is time limited.

23.

C1 (i) of the allocation of, or entitlement to, the resource - attach evidence and go to Q23(vi)

(1 (ii) the chief executive of the department administering the resource is satisfied the
development is consistent with an allocation of, or entitlement to, the resource - go
to Q23

D (iii) the chief executive of the department administering the resource is satisfied the

development application may proceed in the absence of an allocation of, or
entitlement to, the resource - go to Q23

Evidence of the resource entitlement:

(i) Resource entitlement / = details
(ii) Name of a officer
(iii) Position of “eases officer

(iv) Signature of delegated officer

(vii) Official stamp of the department

administering the resource (if
applicable)

 

 

 

 

 

(v) Date

(vi) pe date of evidence a

 

 

 

 

Assessment triggers

This checklist does net apply if the application requires
the completion of Parts A and B of the Form onty. It

24.

Is the IDAS Assessment Checklist completed and attached to this application?

(eaves (JNO - the assessment manager may refuse to accept this application on the

 

 

 

Must be completed for afl other applications. grounds that the application has not been properly made
Plans / drawings / reports 25. Plans/drawings/reports accompanying this application:

oupeat the oa emo med by etal © Plan} Drawing / Report Number

manager, referral agencies and any person viewing

the application during pubic scrutiny or public (ZE-

Notification to understand the scope of the proposat
and any potential impact.

 

  

 

 

 

 

 

 

 

PLEASE NOTE: The assessment manager may refuse to accept an application that, at the time of iodgement, fails to provide all applicable information required by Part A
and any other relevant part of Form 1.

 

OFFICE USE ONLY (appiicable to assessment manager's)

 

 

 

DATE RECENNG Percent $s REFERENCE
FEES) =f Zou | ‘la Jor [ [P23 ven | NemBens loz/i LEoQ |
Notification of Engagement of Private Certifier (Optional format} J r
To, Council. | have been engaged as the private certifier for the buitding work referred to in this application.

 

Date ofengagement / /

Accreditation Number.

 

_ Name: Signature: