Development Applicaton for permit to damage vegetation - OW13/0168 · OPW13/0168

12. Is the payment of a portable long service leave levy applH:able to this application? (Referto notes at the end
of this form for more information.)


00 No--go to question 14               D      Yes



13. Has the portable long service leave levy been paid? (Referto notes at the end of this form for more
information.)

o No
o Yes-complete Table N and submit with this application the yeIJow local govemmentIpriva certilje(s copy of the
         receipted Qleave form

TableN

Amount paid                Date paid          Qleave project number (6cflQit number sIaJting with A. B. E. lor P)

                           (ddlmmlyy)




14. Has the local government agreed to apply a supetseded planning scheme to this application under section
96 of the Sustainable Planning Act 200!1?



    ~ No
    o Yes---pIease provide details below

Name of local government                             Date of written notice given     Reference number of written notice given
                                                     by local government              by kx:algovemment (ifapplicable)
                                                     (ddlmm/yy)




    15. Ust below all of the forms and supporting information that accompany this application (IncludealllDAS
    forms,checklists, mandatory supporting infonnation etc. that wiD be submitted as part of this appQiication. Note: this
    question does not apply for applications made online usng Smart eDA)

Desc ption of attachment or title of aUachment
.
                                                                                                         Method of lodgement to
                                                                                                         assessment manager




116.Applicant’s declaration ,:;&~                                      "
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    IKl By making this application, J declare that aU infonnation in this application istrue and correcI:(Note:it is unlawful to
    provide false or misleading information.)




6                                                                                                                      IDAS form 1-Application details
                                                                                                                        Version 2.0 17 December 2012