DA Form 1 - 134 Ferrells Rd, COOROY

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PART 2 – LOCATION DETAILS

3) Location of the premises (complete 3.1) or 3.2), and 3.3) as applicable)
Note: Provide details below and attach a site plan for any or all premises part of the development application. For further
information, see DA Forms Guide: Relevant plans.
3.1) Street address and lot on plan
Street address AND lot on plan (all lots must be listed), or
Street address AND lot on plan for an adjoining or adjacent property of the premises (appropriate for
      development in water but adjoining or adjacent to land e.g. jetty, pontoon. All lots must be listed).
          Unit No.        Street No.       Street Name and Type                                 Suburb
                          134              FERRELLS ROAD                                        COOROY
 a)
          Postcode        Lot No.          Plan Type and Number (e.g. RP, SP)                   Local Government Area(s)
          4563            8                 Lot 8 RP 202437                                     NOOSA SHIRE
          Unit No.        Street No.       Street Name and Type                                 Suburb

 b)
          Postcode        Lot No.          Plan Type and Number (e.g. RP, SP)                   Local Government Area(s)


3.2) Coordinates of premises (appropriate for development in remote areas, over part of a lot or in water not adjoining or
     adjacent to land e.g. channel dredging in Moreton Bay)
Note: Place each set of coordinates in a separate row.
Coordinates of premises by longitude and latitude
Longitude(s)                      Latitude(s)                   Datum                        Local Government Area(s) (if
                                                                                             applicable)
                                                                 WGS84
                                                                 GDA94
                                                                 Other:
Coordinates of premises by easting and northing
Easting(s)                Northing(s)            Zone Ref. Datum                             Local Government Area(s) (if
                                                                                             applicable)

                                                  54             WGS84
                                                  55             GDA94
                                                  56             Other:
3.3) Additional premises
Additional premises are relevant to this development application and the details of these premises
  have been attached in a schedule to this development application
Not required

4) Identify any of the following that apply to the premises and provide any relevant details
In or adjacent to a water body or watercourse or in or above an aquifer
Name of water body, watercourse or aquifer:
On strategic port land under the Transport Infrastructure Act 1994
Lot on plan description of strategic port land:
Name of port authority for the lot:
In a tidal area
Name of local government for the tidal area (if
applicable):

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Name of port authority for tidal area (if applicable):
On airport land under the Airport Assets (Restructuring and Disposal) Act 2008
Name of airport:
Listed on the Environmental Management Register (EMR) under the Environmental Protection Act
1994
EMR site identification:
Listed on the Contaminated Land Register (CLR) under the Environmental Protection Act 1994
CLR site identification:


5) Are there any existing easements over the premises?
Note: Easement uses vary throughout Queensland and are to be identified correctly and accurately. For further information on
easements and how they may affect the proposed development, see DA Forms Guide.
Yes – All easement locations, types and dimensions are included in plans submitted with this
        development application
No


PART 3 – DEVELOPMENT DETAILS

Section 1 – Aspects of development
6.1) Provide details about the first development aspect
a) What is the type of development? (tick only one box)
Material change of use            Reconfiguring a lot              Operational work           X      Building work
b) What is the approval type? (tick only one box)
Development permit            X Preliminary approval               Preliminary approval that includes a variation
                                                                      approval
c) What is the level of assessment?
Code assessment                   Impact assessment (requires public notification)
d) Provide a brief description of the proposal (e.g. 6 unit apartment building defined as multi-unit dwelling,
   reconfiguration of 1 lot into 3 lots):

CROSSOVER
e) Relevant plans
Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see
      DA Forms guide: Relevant plans.
Relevant plans of the proposed development are attached to the development application
6.2) Provide details about the second development aspect
a) What is the type of development? (tick only one box)
Material change of use            Reconfiguring a lot              Operational work         X        Building work
b) What is the approval type? (tick only one box)
Development permit                     Preliminary approval Preliminary approval that includes a variation
                                                              approval
c) What is the level of assessment?
Code assessment                   Impact assessment (requires public notification)
d) Provide a brief description of the proposal (e.g. 6 unit apartment building defined as multi-unit dwelling,
reconfiguration of 1 lot into 3 lots):

SECOND ACCESS POINT
e) Relevant plans

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Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see
      DA Forms Guide: Relevant plans.
 Relevant plans of the proposed development are attached to the development application
6.3) Additional aspects of development
 Additional aspects of development are relevant to this development application and the details for
   these aspects that would be required under Part 3 Section 1 of this form have been attached to
   this development application
 Not required

Section 2 – Further development details
7) Does the proposed development application involve any of the following?
Material change of use                Yes – complete division 1 if assessable against a local planning
                                     instrument
                                                                                                                                No
Reconfiguring a lot                   Yes – complete division 2                                                                 No
Operational work                      Yes – complete division 3                                                                 No
Building work                         Yes – complete DA Form 2 – Building work details                                          No

Division 1 – Material change of use
Note: This division is only required to be completed if any part of the development application involves a material change of use
      assessable against a local planning instrument.
8.1) Describe the proposed material change of use
Provide a general description of               Provide the planning scheme                   Number of                Gross floor
the proposed use                               definition (include each definition in a      dwelling units (if       area (m2)
                                               new row)                                      applicable)              (if applicable)




8.2) Does the proposed use involve the use of existing buildings on the premises?
 Yes
 No     X

Division 2 – Reconfiguring a lot
Note: This division is only required to be completed if any part of the development application involves reconfiguring a lot.
9.1) What is the total number of existing lots making up the premises?


9.2) What is the nature of the lot reconfiguration? (tick all applicable boxes)
 Subdivision (complete 10))                                  Dividing land into parts by agreement (complete 11))
 Boundary realignment (complete 12))                         Creating or changing an easement giving access to a
                                                               lot from a constructed road (complete 13))

10) Subdivision
10.1) For this development, how many lots are being created and what is the intended use of those
lots:
Intended use of lots                Residential             Commercial            Industrial               Other, please specify:
created

Number of lots created
10.2) Will the subdivision be staged?

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Yes – provide additional details below
No
How many stages will the works include?
What stage(s) will this development
application apply to?




11) Dividing land into parts by agreement – how many parts are being created and what is the
    intended use of the parts?
Intended use of parts               Residential            Commercial            Industrial            Other, please specify:
created

Number of parts created

12) Boundary realignment
12.1) What are the current and proposed areas for each lot comprising the premises?
                         Current lot                                                       Proposed lot
Lot on plan description           Area (m2)                       Lot on plan description           Area (m2)




12.2) What is the reason for the boundary realignment?



13) What are the dimensions and nature of any existing easements being changed and/or any
proposed easement? (attach schedule if there are more than two easements)
Existing or             Width          Length (m) Purpose of the easement? (e.g.                   Identify the land/lot(s)
proposed?               (m)                            pedestrian access)                          benefitted by the
                                                                                                   easement




Division 3 – Operational work
Note: This division is only required to be completed if any part of the development application involves operational work.
14.1) What is the nature of the operational work?
Road work                                         Stormwater                         Water infrastructure
Drainage work                                     Earthworks                         Sewage infrastructure
Landscaping                                       Signage                            Clearing vegetation
Other – please specify:               Second property Crossover
14.2) Is the operational work necessary to facilitate the creation of new lots? (e.g. subdivision)
Yes – specify number of new lots:
No
14.3) What is the monetary value of the proposed operational work? (include GST, materials and labour)
$    $4,000.00

PART 4 – ASSESSMENT MANAGER DETAILS

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15) Identify the assessment manager(s) who will be assessing this development application
       Noosa Shire Council
16) Has the local government agreed to apply a superseded planning scheme for this development
application?
Yes – a copy of the decision notice is attached to this development application
The local government is taken to have agreed to the superseded planning scheme request – relevant
   documents attached
No



PART 5 – REFERRAL DETAILS
17) Does this development application include any aspects that have any referral requirements?
Note: A development application will require referral if prescribed by the Planning Regulation 2017.
No, there are no referral requirements relevant to any development aspects identified in this
  development application – proceed to Part 6
Matters requiring referral to the Chief Executive of the Planning Act 2016:
 Clearing native vegetation
 Contaminated land (unexploded ordnance)
 Environmentally relevant activities (ERA) (only if the ERA has not been devolved to a local government)
 Fisheries – aquaculture
 Fisheries – declared fish habitat area
 Fisheries – marine plants
 Fisheries – waterway barrier works
 Hazardous chemical facilities
 Heritage places – Queensland heritage place (on or near a Queensland heritage place)
 Infrastructure-related referrals – designated premises
 Infrastructure-related referrals – state transport infrastructure
 Infrastructure-related referrals – State transport corridor and future State transport corridor
 Infrastructure-related referrals – State-controlled transport tunnels and future state-controlled
transport tunnels
 Infrastructure-related referrals – near a state-controlled road intersection
 Koala habitat in SEQ region – interfering with koala habitat in koala habitat areas outside koala
priority areas
 Koala habitat in SEQ region – key resource areas
 Ports – Brisbane core port land – near a State transport corridor or future State transport corridor
 Ports – Brisbane core port land – environmentally relevant activity (ERA)
 Ports – Brisbane core port land – tidal works or work in a coastal management district
 Ports – Brisbane core port land – hazardous chemical facility
 Ports – Brisbane core port land – taking or interfering with water
 Ports – Brisbane core port land – referable dams
 Ports – Brisbane core port land – fisheries
 Ports – Land within Port of Brisbane’s port limits (below high-water mark)
 SEQ development area
 SEQ regional landscape and rural production area or SEQ rural living area – tourist activity or sport
    and recreation activity
 SEQ regional landscape and rural production area or SEQ rural living area – community activity
 SEQ regional landscape and rural production area or SEQ rural living area – indoor recreation
 SEQ regional landscape and rural production area or SEQ rural living area – urban activity
 SEQ regional landscape and rural production area or SEQ rural living area – combined use
 SEQ northern inter-urban break – tourist activity or sport and recreation activity

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SEQ northern inter-urban break – community activity
SEQ northern inter-urban break – indoor recreation
SEQ northern inter-urban break – urban activity
SEQ northern inter-urban break – combined use
Tidal works or works in a coastal management district
Reconfiguring a lot in a coastal management district or for a canal
Erosion prone area in a coastal management district
Urban design
Water-related development – taking or interfering with water
Water-related development – removing quarry material (from a watercourse or lake)
Water-related development – referable dams
Water-related development –levees (category 3 levees only)
Wetland protection area
Matters requiring referral to the local government:
Airport land
Environmentally relevant activities (ERA) (only if the ERA has been devolved to local government)
Heritage places – Local heritage places
Matters requiring referral to the Chief Executive of the distribution entity or transmission entity:
Infrastructure-related referrals – Electricity infrastructure
Matters requiring referral to:
• The Chief Executive of the holder of the licence, if not an individual
• The holder of the licence, if the holder of the licence is an individual
Infrastructure-related referrals – Oil and gas infrastructure
Matters requiring referral to the Brisbane City Council:
Ports – Brisbane core port land
Matters requiring referral to the Minister responsible for administering the Transport
Infrastructure Act 1994:
 Ports – Brisbane core port land (where inconsistent with the Brisbane port LUP for transport reasons)
 Ports – Strategic port land
Matters requiring referral to the relevant port operator, if applicant is not port operator:
Ports – Land within Port of Brisbane’s port limits (below high-water mark)
Matters requiring referral to the Chief Executive of the relevant port authority:
Ports – Land within limits of another port (below high-water mark)
Matters requiring referral to the Gold Coast Waterways Authority:
Tidal works or work in a coastal management district (in Gold Coast waters)
Matters requiring referral to the Queensland Fire and Emergency Service:
Tidal works or work in a coastal management district (involving a marina (more than six vessel berths))

18) Has any referral agency provided a referral response for this development application?
Yes – referral response(s) received and listed below are attached to this development application
No
Referral requirement                                       Referral agency                  Date of referral
                                                                                            response




Identify and describe any changes made to the proposed development application that was the
subject of the referral response and this development application, or include details in a schedule to
this development application (if applicable).

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PART 6 – INFORMATION REQUEST

19) Information request under Part 3 of the DA Rules
I agree to receive an information request if determined necessary for this development application
I do not agree to accept an information request for this development application
Note: By not agreeing to accept an information request I, the applicant, acknowledge:
 •    that this development application will be assessed and decided based on the information provided when making this
      development application and the assessment manager and any referral agencies relevant to the development application
      are not obligated under the DA Rules to accept any additional information provided by the applicant for the development
      application unless agreed to by the relevant parties
 •    Part 3 of the DA Rules will still apply if the application is an application listed under section 11.3 of the DA Rules.
Further advice about information requests is contained in the DA Forms Guide.


PART 7 – FURTHER DETAILS

20) Are there any associated development applications or current approvals? (e.g. a preliminary approval)
Yes – provide details below or include details in a schedule to this development application
No X
List of approval/development             Reference number               Date                           Assessment
application references                                                                                 manager
Approval
Development application
Approval
Development application

21) Has the portable long service leave levy been paid? (only applicable to development applications involving
    building work or operational work)
Yes – a copy of the receipted QLeave form is attached to this development application
No – I, the applicant will provide evidence that the portable long service leave levy has been paid
  before the assessment manager decides the development application. I acknowledge that the
  assessment manager may give a development approval only if I provide evidence that the portable
  long service leave levy has been paid
Not applicable (e.g. building and construction work is less than $150,000 excluding GST)
Amount paid                       Date paid (dd/mm/yy)                         QLeave levy number (A, B or E)
$


22) Is this development application in response to a show cause notice or required as a result of an
enforcement notice?
Yes – show cause or enforcement notice is attached
No X

23) Further legislative requirements
Environmentally relevant activities
23.1) Is this development application also taken to be an application for an environmental authority for
an Environmentally Relevant Activity (ERA) under section 115 of the Environmental Protection Act
1994?
Yes – the required attachment (form ESR/2015/1791) for an application for an environmental
  authority accompanies this development application, and details are provided in the table below

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No        X
Note: Application for an environmental authority can be found by searching “ESR/2015/1791” as a search term at
www.qld.gov.au. An ERA requires an environmental authority to operate. See www.business.qld.gov.au for further information.

Proposed ERA number:                                             Proposed ERA threshold:
Proposed ERA name:
Multiple ERAs are applicable to this development application and the details have been attached in a
  schedule to this development application.
Hazardous chemical facilities
23.2) Is this development application for a hazardous chemical facility?
Yes – Form 69: Notification of a facility exceeding 10% of schedule 15 threshold is attached to this
  development application
No
Note: See www.business.qld.gov.au for further information about hazardous chemical notifications.




Clearing native vegetation
23.3) Does this development application involve clearing native vegetation that requires written
confirmation that the chief executive of the Vegetation Management Act 1999 is satisfied the clearing
is for a relevant purpose under section 22A of the Vegetation Management Act 1999?
Yes – this development application includes written confirmation from the chief executive of the
   Vegetation Management Act 1999 (s22A determination)
No
Note: 1. Where a development application for operational work or material change of use requires a s22A determination and
         this is not included, the development application is prohibited development.
      2. See https://www.qld.gov.au/environment/land/vegetation/applying for further information on how to obtain a s22A
        determination.
Environmental offsets
23.4) Is this development application taken to be a prescribed activity that may have a significant
residual impact on a prescribed environmental matter under the Environmental Offsets Act 2014?
Yes – I acknowledge that an environmental offset must be provided for any prescribed activity
  assessed as having a significant residual impact on a prescribed environmental matter
No
Note: The environmental offset section of the Queensland Government’s website can be accessed at www.qld.gov.au for
further information on environmental offsets.
Koala habitat in SEQ Region
23.5) Does this development application involve a material change of use, reconfiguring a lot or
operational work which is assessable development under Schedule 10, Part 10 of the Planning
Regulation 2017?
Yes – the development application involves premises in the koala habitat area in the koala priority
area
Yes – the development application involves premises in the koala habitat area outside the koala
priority area
No
Note: If a koala habitat area determination has been obtained for this premises and is current over the land, it should be
provided as part of this development application. See koala habitat area guidance materials at www.des.qld.gov.au for further
information.
Water resources
23.6) Does this development application involve taking or interfering with underground water
through an artesian or subartesian bore, taking or interfering with water in a watercourse, lake
or spring, or taking overland flow water under the Water Act 2000?
Yes – the relevant template is completed and attached to this development application and I
  acknowledge that a relevant authorisation or licence under the Water Act 2000 may be required
  prior to commencing development

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No
Note: Contact the Department of Natural Resources, Mines and Energy at www.dnrme.qld.gov.au for further information.
DA templates are available from https://planning.dsdmip.qld.gov.au/. If the development application involves:
• Taking or interfering with underground water through an artesian or subartesian bore: complete DA Form 1 Template 1
• Taking or interfering with water in a watercourse, lake or spring: complete DA Form1 Template 2
•    Taking overland flow water: complete DA Form 1 Template 3.
Waterway barrier works
23.7) Does this application involve waterway barrier works?
Yes – the relevant template is completed and attached to this development application
No
DA templates are available from https://planning.dsdmip.qld.gov.au/. For a development application involving waterway barrier
works, complete DA Form 1 Template 4.
Marine activities
23.8) Does this development application involve aquaculture, works within a declared fish habitat
area or removal, disturbance or destruction of marine plants?
Yes – an associated resource allocation authority is attached to this development application, if
  required under the Fisheries Act 1994
No
Note: See guidance materials at www.daf.qld.gov.au for further information.
Quarry materials from a watercourse or lake
23.9) Does this development application involve the removal of quarry materials from a
watercourse or lake under the Water Act 2000?
Yes – I acknowledge that a quarry material allocation notice must be obtained prior to commencing
development
No
Note: Contact the Department of Natural Resources, Mines and Energy at www.dnrme.qld.gov.au and
www.business.qld.gov.au for further information.

Quarry materials from land under tidal waters
23.10) Does this development application involve the removal of quarry materials from land under
tidal water under the Coastal Protection and Management Act 1995?
Yes – I acknowledge that a quarry material allocation notice must be obtained prior to commencing
development
No
Note: Contact the Department of Environment and Science at www.des.qld.gov.au for further information.
Referable dams
23.11) Does this development application involve a referable dam required to be failure impact
assessed under section 343 of the Water Supply (Safety and Reliability) Act 2008 (the Water Supply
Act)?
Yes – the ‘Notice Accepting a Failure Impact Assessment’ from the chief executive administering the
  Water Supply Act is attached to this development application
No
Note: See guidance materials at www.dnrme.qld.gov.au for further information.
Tidal work or development within a coastal management district
23.12) Does this development application involve tidal work or development in a coastal
management district?
Yes – the following is included with this development application:
      Evidence the proposal meets the code for assessable development that is prescribed tidal
         work (only required if application involves prescribed tidal work)
      A certificate of title
No
Note: See guidance materials at www.des.qld.gov.au for further information.

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Queensland and local heritage places
23.13) Does this development application propose development on or adjoining a place entered in the
Queensland heritage register or on a place entered in a local government’s Local Heritage
Register?
Yes – details of the heritage place are provided in the table below
No
Note: See guidance materials at www.des.qld.gov.au for information requirements regarding development of Queensland
heritage places.
Name of the heritage
                                                                   Place ID:
place:
Brothels
23.14) Does this development application involve a material change of use for a brothel?
Yes – this development application demonstrates how the proposal meets the code for a
  development application for a brothel under Schedule 3 of the Prostitution Regulation 2014
No
Decision under section 62 of the Transport Infrastructure Act 1994
23.15) Does this development application involve new or changed access to a state-controlled road?
Yes – this application will be taken to be an application for a decision under section 62 of the
  Transport Infrastructure Act 1994 (subject to the conditions in section 75 of the Transport
  Infrastructure Act 1994 being satisfied)
No


Walkable neighbourhoods assessment benchmarks under Schedule 12A of the Planning
  Regulation
23.16) Does this development application involve reconfiguring a lot into 2 or more lots in certain
residential zones (except rural residential zones), where at least one road is created or extended?
 Yes – Schedule 12A is applicable to the development application and the assessment benchmarks
contained in schedule 12A have been considered
 No
Note: See guidance materials at www.planning.dsdmip.qld.gov.au for further information.


PART 8 – CHECKLIST AND APPLICANT DECLARATION

24) Development application checklist
I have identified the assessment manager in question 15 and all relevant
referral requirement(s) in question 17                                                               Yes
Note: See the Planning Regulation 2017 for referral requirements
If building work is associated with the proposed development, Parts 4 to 6 of                        Yes
DA Form 2 – Building work details have been completed and attached to this
development application                                                                              Not applicable

Supporting information addressing any applicable assessment benchmarks is
with the development application
Note: This is a mandatory requirement and includes any relevant templates under question 23, a
planning report and any technical reports required by the relevant categorising instruments (e.g.    Yes
local government planning schemes, State Planning Policy, State Development Assessment
Provisions). For further information, see DA HYPERLINK "https://planning.dilgp.qld.gov.au/"Forms
HYPERLINK "https://planning.dilgp.qld.gov.au/"G HYPERLINK
"https://planning.dilgp.qld.gov.au/"uide: Planning Report Template.
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.   Yes
For further information, see DA HYPERLINK "https://planning.dilgp.qld.gov.au/"Forms
HYPERLINK "https://planning.dilgp.qld.gov.au/"G HYPERLINK

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"https://planning.dilgp.qld.gov.au/"uide: Relevant plans.
The portable long service leave levy for QLeave has been paid, or will be paid             Yes
before a development permit is issued (see 21)                                             Not applicable

25) 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 relevant 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 9 – FOR COMPLETION OF THE ASSESSMENT MANAGER –
FOR OFFICE USE ONLY

Date received:                                   Reference number(s):


Notification of engagement of alternative assessment manager
Prescribed assessment manager
Name of chosen assessment manager
Date chosen assessment manager engaged
Contact number of chosen assessment manager
Relevant licence number(s) of chosen
assessment manager

QLeave notification and payment
Note: For completion by assessment manager if applicable
Description of the work
QLeave project number
Amount paid ($)                                                     Date paid (dd/mm/yy)
Date receipted form sighted by assessment
manager

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Name of officer who sighted the form