16394 DA Form 1 · OPW19/0242

 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
 X No
 Referral requirement                                  Referral agency                                   Date of referral response
 STATE OWNERS CONSENT                                  DNRME                                             3.10.19
 SARA REFERRAL                                         SARA – DES/MSQ
 Identify and describe any changes made to the proposed development application that was the subject of the referral response and the
 development application the subject of this form, or include details in a schedule to this development application (if applicable).


PART 6 – INFORMATION REQUEST
 19) Information request under Part 3 of the DA Rules
 X 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
 X No
 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
 X 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
 $


 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
 X No


 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
 X No
 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:

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                                                                                                    DA Form 1 – Development Application details
                                                                                                                  Version 1.1— 22 JUNE 2018