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

INTEGRATED PLANNING ACT 1997 Part E, Version 2.0, 4 October 2004

by law to “sight” an approved fo sue by /5. Has the PLSL levy been paid?
Oeave which sprites that the levy COYES — com

oO NO -~ the applicable levy must be paid before a development permit can be given for the works

6. How much was paid?

L |

7. What is the receipt number of the payment?

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PLEASE NOTE
This application cannot be accepted unless accompanied by Part A of Form 1.

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

 

 

OFFICE USE ONLY {applicable to assessment manager}

 

 

 

 

 

 

DATE RECEIVED | | REFERENCE NUMBER/S
(i) Isa PLSL levy applicable in this instance? (no (C1 YES - complete Qi)
(ii) Has the approved form (issued by QLeave and which signifies that the PLSL levy has been paid) been sighted by the assessment
manager / private certifier at the time of lodgement of this application? [No 1 YES - provide receipt detaits below