13967 IDAS Form 23 · OPW16/0237

 For prescribed tidal works, details of how the proposed work addresses         X   Confirmed
 the IDAS code for prescribed tidal work in the Coastal Protection and              Not applicable
 Management Regulation 2003, schedule 4A.
 If applicable, certification that the design of tidal works is suitable for    X   Confirmed
 intended use, signed by a Registered Professional Engineer of                      Not applicable
 Queensland (or equivalent).
 For applications involving material change of use
 Plans certified by a registered professional engineer of Queensland                Confirmed
 (RPEQ) or a registered surveyor showing:                                           Not applicable
 •   the real property description and boundaries of the land
 •   the proposed works in relation to the location of the coastal
     management district and coastal hazards.
 For applications involving reconfiguring a lot
 Plans certified by a registered surveyor showing:                                  Confirmed
 •   the real property description and boundaries of the land                       Not applicable
 •   The location of the coastal management district and coastal hazards
     in relation to the land being reconfigured
 •   Any land being surrendered as a separate lot on the plan of
     subdivision.
 For applications involving building works seaward of a coastal building line
 Plans certified by a registered professional engineer of Queensland                Confirmed
 (RPEQ):                                                                            Not applicable
 •   the real property description and boundaries of the land
 •   the proposed works in relation to the location of the coastal building
     line.

Notes for completing this form
•   Please ensure all applicable fees are paid, noting that referral agency fees are to be paid to the Department of
    Environment and Heritage Protection.
•   For an application requiring referral to the Department of Transport and Main Roads (DTMR), it is recommended
    that the applicant contact DTMR to ensure that required information for assessment of the application is provided.

Privacy—Please refer to your assessment manager, referral agency and/or building certifier for further details on the
use of information recorded in this form.


OFFICE USE ONLY

 Date received                                             Reference numbers

The Sustainable Planning Act 2009 is administered by the Department of Infrastructure, Local Government and
Planning. This form and all other required application materials should be sent to your assessment manager and any
referral agency.




                                                                               IDAS form 23—Tidal works and development within
                                                                                                the coastal management district
                                                                                                    Version 3.1—3 August 2015