Operational Works Application OPW17/0039

                                                                    Department of Infrastructure,   Local Government and Planning


Table J

Lot on plan description for strategic port land                       Port authority for the lot




Table K

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




B.     Are there any existing    easements    on the premises?    (e.g. for vehicular access, electricity, overland flow,
       water etc)

       No      0    Yes-ensure   the type, location and dimension of each easement is included in the plans submitted


9.     Does the proposal    include    new building   work or operational   work on the premises?          (Including any
       services)

o No                Yes-ensure   the nature, location and dimension of proposed works are included in plans submitted


10.    Is the payment of a portable long service       leave levy applicable     to this application?     (Refer to notes at the
       end of this form for more information.)

g      No-go   to question 11         DYes

10a.   Has the portable    long service leave levy been paid? (Refer to notes at the end of this form for more
       information.)

5t     No
o Yes-eomplete Table L and submit, with this application, the local government/private certifier's copy of the
       accepted QLeave form

Table L

Amount paid                                                        Date paid          QLeave project number (6 digit number
                                                                   (dd/mmlyy)         starting with A, B, E, L, P or S)




11.    Has the local government agreed to apply a superseded            planning    scheme to this application       under
       section 96 of the Sustainable Planning Act 2009?


r::(   No

o      Yes-please    provide details below


Name of local government                          Date of written notice given      Reference number of written notice given
                                                  by local government               by local government (if applicable)
                                                  (dd/mmlyy)




                                                                                                    IDAS form 1-Application details
                                                                                                        Version 4.3-5 December 2016