DA Form 1 21 Myles St

Page 2

PART 2 — LOCATION DETAILS

         

Vshinctciar-\erelg sss
[4 Street address AND lot on plan (ail iots must be listed), Or

LJ 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 eg. jetty, pontoon. All lots must be be listed).

     
    
  
   
  
  
   
 

 

 

 

 

 

   
 

Unit No. | Street No. Mas Street Name and Type ‘i Ts ~~~ Suburb

‘ 2 5) (NSES SIRT ene
Postcode | LotNo. _| Plan Type and Number (e.g. | RP, P, SP) ___| Local Government Area(s}
4ses| | |RPIBIZS9 [NOOSA __

Unit No. | StreetNo. | Street Name and Type _ Suburb

 

‘Local Government Area(s)

 

 

 

 

 

 

 
    

L [s] Coordinates of premises by | longitude and latitude

Longitude(s) Latitude(s)

Local Government Area(s) (ft applicable) |

 

| | Cl epags

letieme ds (Tad i>
oO Coordinates of premises by easting and northing _

| Easting(s) T Northing(s) if Zone Ref. | Datum : Local Government Area(s) (if applicable) | |

| Seep frogs ony Mave-gs Sig cigs gt

| ifs (1 wese4
0155 11 Gpas4
O56 (C0 Other:

 

 

 

J 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

    

in or adjacent to a water body or watercourse or in or above an aquifer

Name of water body, watercourse or aquifer: he NMOoOSA RIVER

1 On strategic port land under the Transport Infrastructure e Act 1904 __ Rete ed
Lot on pian description of strategic port land:

Name of port authority for the lot:
(J tna tidal area

Name of local government for the tidal area (if applicable):
Name of of port authority for tidal area (if applicable):

(1 On airport land under the Airport Assets (Restructuring and Disposal) Act 2008
Name of Fairport:

 

 

 

 

 

 

 

 

 

 

 

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(1 Listed on the Environmental Management Register (EMR) under th the Environmental Protection Act 1994

1
4
EMR site identification: GuleaePina A irAtneNle ;

(1 Listed on the Contaminated Land Register (CLR) under the Environmental Protection Act 1994

| CLR site identification: :

To erolee leis acca oiee Loree

  

Cl Yea = Alt easement locations, types and dimensions are included in plans submitted with this development
application

(SIN ae el

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)

 

OM Jinaraina change of use _ uo Reconfiguring a lot oO Operational work 0 Building work

 

a) Development permit 1 Preliminary approval _ OPreliminary approval that includes a variation approval
EY What is the level of assessment?

 

 

 

 

Oo Code assessment. ia ] Impact assessment (racuires public notification)
d) Provide a brief description of the proposal (e.g. 6 unit apartment building defined as mnultiunit dwettiag, reconfiguration of 7 lot into 3)
lots):

 

Ra $5 VER ON NATMRE STRIP MYLES STREG

 

 

Shoo pe Rca Any

e) Relevant plans
Note; Relevant pe are required to be submitted for all aspects of this development application. For further information, see DA Forms guide:

 

CL] Relevant plans of the ‘proposed development are attached to the development application _

 

6.2) Provide details about the secon velopment aspect

   

 

 

 

 

 

 

 

| a) What i is the type of development? (tick onlyone box)

| CJ Material change of use [JReconfiguringalot a) | Operational work | __DBuitding work

b) What is the approval type? (tick only ane box) Sten ee

(J Development permit (1 Preliminary approval oO Preliminary approval that includes a a variation approval
|) What is the level of assessment? ees. ee

| C1 Code assessment Oo impact assessment (requires public notification) _

 

| d) Provide a brief description of the proposal (e.g. 6 unit apartment building defined as mult-unit dwelling, reconfiguration of 1 lot into 3
lots):

 

Seeendany ‘Avie Was.) access aAcms nahre stip _ id
e) Relevant plans -7 >
Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms Guide:
_ Relevant plans.

A Relevant plans of the proposed development are attached to the development application

   

 

 

oO 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

(Net required

 

 

 

 

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Section 2 — Further development details

   
 

(J Yes = complete di Sion 1 if assessable against a local planning instrument

 

Material change of use

 

 

[ Reconfiguring 2 lot (Yes - “completo ivision 2
| Operational work 7 £1 Yes ~ complete division Be pe tegen Rc ta ee es etek
| Building work (0 Yes — complete DA Form 2 — Building work details |

Division 1 — Material change of use

Note. This division is only required to be compieted if sny part of the development application involves a materia! change of use assessable against a
focal oherming B

    
   

; sec material change of use

Provide a persed description of the Provide the planning scheme definition | Number of dwalling | Gross floor
proposed use (include each definition ino new row) units (it appiicatie) area (m’)
@ applicable) |

8.2) Does the proposed use involve the use of existing buildings on the premises?

Division 2 — Reconliguing alot
Note: ie ain ° presi
PAs Sr

 

 

9.2} What is the nature o
\O Subdivision (complate 10}) Oivicing land into parts by agreement (compiste 17)

Oo
O Boundary realignment (completo 12) () Creating or changing an easement giving access to a lot
| from a Constructed road (compiete 13))

     

feloprment, how many lots are being created and what is the intended use of those lots:

| Commercial

C1] Yes— ine additional details below
| CNo

How many stages will the works include?

What stage(s) will this development application
apply to?

 

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11) Divi ste and into parts by w Many parts aro being created and what is the intended use of the

Other, please specify:

   

‘or each lot cor

  
  

 

= anc proposed &
Pe pea: Current tot
| Lot on plan description ae Area (me)

   
   

mpnising

  

 

Proposed lot
Lot on plan description LA

      
     
    

rozson for the boundary realignment?

   

Vnat is the

 

ure of any existing easements being changed and/or any proposed easement?
eels nd]
| Purpose of the easement? (eg. Identify the land/tot(s)
| pedestian sccess) benefitted by the easement

14 1) What is the nature of the operational work?
[J Stormwater (0 Water infrastructure
(C0 Earthworks CO Sewage infrastructure
CO Signage. ____F. Glearing vegetation
Secomdan

14.2) Is the operat i work necessary to facilitate the creation of new lots? (¢ 9 subdivision

 

Pe Sue cM She a 12) bate xt no ebro dia eee ok Ronan ta ee eee na

 

 

Pirate eels)

Peet aac eer eae stick teehee )\ eee tla for this development application?

_] Yes — a copy of the decision notice is attached to this development scolcelan
L) The focal government is taken to have agreed to the superseded planning scheme request — relevant Socuments |
attached

LCINo

 

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PART 5 — REFERRAL DETAILS

  

| oO eon are ho referral Pca relevant to any development aspects identified in this development
j cation on proceed to

fa nic stndeibneantanendeneitn a

Matters requiring raferral to the Chief Executive of the Planning Act 2016:

(1 Clearing native vegetation

(J Contaminated land (unexploded ordnance)

(C) Environmentally rolevant activities (ERA) fonty if she ERA has not beon devolved to a Jocal govamment)

(CO Fisheries = aquaculture

(CO Fisheties = dectared fish habitst area

(J Fisheries — marine plants

(J Fisheries — waterway barrier works

(1 Hazardous chemical facilities

(CO Heritage places - Queensland heritage place (an or new a Queensland hentags place)

(0 Infrastructure-reiated referrals . designated premises

(1 Infrastructure-rolated referrals | state transport infrastructure

(J Infrastructure-related referrals — Stato transport corridor and future State transport corridor

(_] Infrastructure-reisted referrals - State-contolled transport tunnels and future state-controtied transport tunnels

( Infrastructure-related referrals ~ near a state-controfied 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 aroas

(J Ports — Brisbane core port land — near a State transport cofridor or future State transport corridor

(J Ports = Brisbane core port land — environmentally relevant activity (ERA)

CJ Ports - Brisbane core port land — tidal works or work in a coastal management district

(C) Ports — Brisbane core port land — hazardous chemical facility

(J Ports — Brisbane core port land — taking or interfering with water

(1 Ports ~ Brisbane core port land — referable dams

(J Ports -- Brisbane core port land — fisheries

C) Ports — Land within Port of Brisbane's port limits (befow high-water mark)

(1 SEQ development area

(J SEQ regional landscape and rura! production area or SEQ rural living area - tourist activity or sport and
recreation activity

(J 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

C1 SEQ regional landscape and rural production area or SEQ rural living area — urban activity

(1) SEQ regional landscape and rural production area or SEQ rural living area — combined use

C) Tidal works or works in a coastal management district

| () Reconfiguring a lot in a coastal management district or for a canal

C1] Erosion prone area in a coastal management district

UO urban design

| C1] Water-related development ~ taking or interforing with water

() Water-related development — removing quarry material (from » watorcourse or taka)

(] Water-related development — referable dams

(1 Water-retated development -levees jcategury 3 levers only}

(1) Wetland protection area ee ia

Matters requiring referral to the local government:

(Airport land

| C Environmentally relevant activities (ERA) (only i the ERA has been devolved to local goverment)

 

 

 

 

 

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(1) Heritage places ~ Local heritage places

Matters requiring referral to the Chief Executive of the distribution entity or transmission entity:
(CL 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
(1 infrastructure-related referrals — Oil and gas infrastructure

Matters requiring referral to the Brisbane City Council:

C] 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 Brishane port LUP tor transport reasons)
[1] Ports — Strategic | port land

Matters requiring referral to the relevant port operator, if applicant i is not port operator:
() Ports — Land within Port of Brisbane's port limits (nefow high-wafar mark)

 

 

a ee

Matters requiring referral to the Chief Executive of the relevant port authority:
(1 Ports — Land within limits of another port (below high. weator mark)

Mattors requiring referral to the Gotd Coast Waterways Authority:
(CO Tidal works or work in a coastal management district {ar Gold Coast waters)

Matters requiring reforral to the Queensland Fire and Emergency Service:
(CF Tidal works or work in a coastal management district (involving a marina (more than six ves! berths))

 

 
   
 

CI Yes = referral reaponeets) received and listed below are attached to this aaenberand ‘soplicaton
L]No eA
Referral requirement Referral agency Dato of referral reeporieg }

 

 

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 developmerit application
(if appitcabie) a

PART 6 — INFORMATION REQUEST

  

[-}T agree to receive an information request if determined necessary for this development application

(J | do not agree to accept an information request for this development application |

Note: By not egreeing to accept an information request I, he applicant, acknowledge: |

* that this develonment application will be assessed and decided based on the information provided whan making this devalooment }
application and the assessment manager and any roferral agencies relevant to the development application are not abliguied under the DA |
Rules fo accept any additional information provided by the applicant for the development apptication uniass agreed fo by the refevant j

* = Part 2 of the DA Rules will stl apply if the sppiication Is an apwication listed under sxchori 17.3 of the DA Rutes

Further schiice about sornason requests & rontewred 67 te 28 Forme Guage A

 

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PART 7 — FURTHER DETAILS

 

Wes e) Gee hi gia as is)e celts

C1 Yes - ROH details below or include details in a schedule to this development ai application
CI No

List of approval/development ; "Reference number : | Date | Assessment
application references ‘ | manager

0 Development application
L] Approval
(1 Development application

ce leave levy been paid?

 

ry Ye = @ Gopy Of the receipted QLeave form is attached to this development application

(7) No — |, the applicant will provide evidence that the portable long service leave lavy has been paid before the
assassment manager decides the development application. | acknowledge that the assessment manager may
give a Gevelopment approval onty if | provide evidence that the portable long service leave levy has been paid

(0 Not applicable (@.g. building and construction work is Jess than $150,000 exctuding GST)

Amount paid Date paid (dd/mmiyy) | QLeave levy number nber (A, B or rE)

$ ey eC RI LL AI, aM |

 

 

 

 

   

C Yes = the required attachment {form ESR/2015/1791) for an srinlicdaien for an environmental authority
accompanies this development application, and details are provided In the table below
[C] No

Note; Application for an environmental authority can be found by searching “ESR/201S/1797" as 4 search lever at vow gle. goy cra. An ERA
requires an erivircnmental authority to operate Soo ww. business. gid qov.au for further information
Proposed ERA number: ] Proposed ERA threshold: [|
Proposed ERA name:

;O Multipioe 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) ist application for a hazardous chemical facility?
(] Yes ~ Form » 69: Nadtcation of a facility exceeding 10% af schedule 15 threshold is attached to this development
application
iL) No

| Note: Sec iw. hysinnss qld gov au for furthor information about hazardous chemical notifications

 

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eae

 

ing native vegetation

development application involve clearing native vegetation that requires wrtt

executive of the Vegelabon Management Act 1999 is satisfied the c
elimina eee lie ane

(] Yes — this development appfication includes written confirmation from the chief executive of the Vegetation
Management Act 1999 (s22A determination)
[J No
Note: 1. Where a development appiicatian for operational work oy materiel! change of use requires 2 s22A determination and this i nol included,
the development zpplication is prohibited development.
2. Seo hips Jwww old gov meen vironment land vegetation 2pg ying for further information an how to obtain » $22A determination,

siisenl-lilosa nine

 

     

EEE offsets

 

= Yes — | acknowledge that an environmental offset must be provided % for any prescribed activity assessed as
having a significant residual impact on a prescribed environmental matter
LI No

Note: The environmental offset section of the Queensland Govemmeant’s website can be sccessed af ww. lf new au for further Information ah

   

Koala habitat in SEQ Region

application involve 2 ma’

a ent under S .
Yes ~ the development application involves premises in the koala habitat area in the koala priority area j
(1) Yes — the development application involves promises in the koala habitat area outside the koala priority area |

  
   

Note: ifa koals habitat sree determination hiss been oblsined for this premises and Is Current over the land, & should be provided a5 part of this
development application See koale habitet ares guidance materials af wyew. oes. gil gov ay for further information.

MPO lm le Leer

~.

2

artesian or aaearaies aoe Seka or interfering with water in a watercourse, lake or spring, or taking
overland flow water under the Water Act 2000?

| C) Yes - the relevant template is completed and attached to this development application and | acknowledge that a
relevant authorisation or licence under the Water Act 2000 may be required prior to commencing development
C1No

Note: Contac! the Department of Natural Resources, Mines and Energy at ww dorine.gid.gov.au for further information

 

DA templates are avaiable trom https panning dsdimip.cid.gov.dul. if the development application invelves:
}° Taking or interfering with underground water through an ertesien or subertesion bure complete DA Form 1 Template 1
| + Taking or interfering with water in a watercourse, jake or spring. cdrnpiete DA Furmt Template 2

t

Taking overland flow water: campleté DA Fon 1 Template 2.

NEI CRv rN Medgar e
VAM ON Oe RU ol eee Riri att Smo lis, Unis te

LJ Yes — the relevant template is completed and attachod to this development application
DA templates are avaiable from https panning dsomip alt goy.aer Fora develiement appticalion involving watenway barrier works, complete
| DA Form 1 Termpitate 4

Ne alACas otha bce}

4

this development application involve aquaculture, works within a declared fish habitat area or
anne disturbance or pret ren of marine plants?

\ () Yes — an associated resource allocation authority is attached to this development application, if required under |
the Fisheries Act 1994
} CL) No

I
:
| Note: See guidance matevials at www.dar git’. gav.au for further information. [

   
 

 

 

  

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Quarry materials from a watercourse or lake
23 rol Blot in oment Application involve the removal of quarry materials from a watercourse or lake

ov. Yes — | acknowledge that a quarry material allocation notice must be obtained prior to commencing development
LINo

Note: Contact the Oepartmant of Natural Resources, Mines and Energy ot wrot.dortre.gid gov ou and www byskress ald goy.eu for further
skowritisti

@ the removal of quarry materials from land under tidal water
t Act 7995?

= Yes =! meres that a quarry vial allocation natice must be obtained prior to commencing development
LINo

Note: Contact fhe Department of Environment and Sclance af www.des, gid gov ev Sor further information.
Referable dams

3 j bility) Act 2008
(7) Yes — the ‘Notice ionaplbg a r ane eet Assessment’ oa ma chief eneculies ecrrinistereg the Water
Supply Act is attached to this development application
LINo

Note: See guidance mafenals af wew domme. gid. gov au for further information.

 

PANO Ra Rohe al ee) eee RCH MO eR ON uae ee eeu nas tite da
(1 Yes < the following is included with this development application: |

i oO Evidence the proposal meets the code for assessable development that is prescribed tidal work (only mquired |
| if application invalves prescribed tidal work)
| (C1 Acortificate of title

nthe Queensland
| Yes details of the = harks place are provided in the table below
[] No

Note Soo guidance matorials at yoyo: SAN. GUY ait for mformotion requirements: regarding Covelopment Queenston’ herkage plocos,

Brothels

23.14) Does this cevelopment application involve a material change of use for a brothel?

(1 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 2074

hanged access to a state-controlled roac?

O Vee this seriicaliog 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)

 

| CONo

 

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Walkable neighbourhoods assessment benchmarks under Schedule 12A of the Planning Requlation

nto 2 or more lots in certain residential zones

  

 

a = fale let sate (Lele
{ al Yee? Schedule 12A is applicable to the develormnent application and the assessment benchmarks contained in
schedule 12A have been considered
CI No
Note: See guidance materials at ww. Dianmng.dsiiip. gid.gov.su for further information

PART 8 — CHECKLIST AND APPLICANT DECLARATION

24) Development application checklist

 

 

| | have identified the assessment manager in question 15 and all retevant referral
| requirement(s) in question 17 va) Yes
| Note Soo the Planning Regulation 2017 for referral requiramonts
If building work is associated with the proposed development, Parts 4 to 6 of DA Form2?- (Yes
Building work details have been completed and attached to this development application <7 Not applicable

Supporting information addressing or applicable assessment benchmarks is with the

development application

Note: This is a mandatory mquirement and includes sny retevanl templates under question 23, a pisnning report = [~] Yos
end any technical reports required by Ure relevent celegorising instruments (e.g. local govemiment planning

schemes, State Planning Policy, State Development Assezsment Provisions). For further information, sce DA

Forres. Guide: Panning Report Template tee eee et x ied sate a
Relevant plans of the development are attached to this devolopment application

Note: Relevant plaris are required to be submitted for all aspects of this developmen application. For furor C1 Yes
| infomation, see DA Fottrs Guide. Relevant plans.

 

 

| The portable long service leave levy for QLéave has been paid, or will be paid before a + [1 Yes
development permit is issued (see 27) ” (1) Not applicable

vi By wiaieng this davelooriant application, | declare that ail information in this development application is true and

correct

E71 Where an email addross is provided In Part 1 of this form, | 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 untawful to intentionally provide false or misleading information

Privacy — Personal information collected in this form will be used ‘by the a assessment | manager and/or chosen

assessment manager, any relevant reforral agency and/or building cortifier (including any professional advisers

which may be engaged by those entities) while processing, assessing and deciding the development application.

All information refating 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 2076 and the Planning Regulation 2017, and the access niles made under the Planning Act 2076 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,

 

   

 

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PART 9 — FOR COMPLETION OF THE ASSESSMENT MANAGER — FOR OFFICE
USE ONLY

Date received: Reference number(s): [ 4 ]

n of engagement of alternative assessment manager

 

| Prescribed assessment manager

E Name of chosen assessment manager
Date choson assessment manager engaged

| Contact number of chosen assessment manager

[ Relevant licence number(s) of chosen assessment
| manager

   

} Descripion of the work
QLeave ) project number i
Amount paid ($) | |

BASF | Date paid (dd/mmiyy)
| Date receipted form sighted by assessment manager _

| Name of officer who sighted the form AT ie ad

 

 

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