Development Application - Part 1 of 2 - IDAS Forms 1 & 6 and Checklist - OPW13/0502

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

    12. 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.)


 X       No-go to question 14        DYes
 o

    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-<:omplete Table N and submit with this application the yellow local governmenUprivate certifier’s copy of the
         receipted QLeave form

 Table N

 Amount paid             Date paid        QLeave project number (6digit number starting with A, B, E, Lor P)

                         (dd/mm/yy)




 14. Has the local government agreed to apply a superseded planning scheme to this application under section
 96 ofthe Sustainable Planning Act 20091


 X       No

 D
 o Yes-please provide details below

 Na me of local government                       Date of written notice given   Reference number of written notice given
                                                by local government             by local government (if applicable)
                                                (dd/mm/yy)




    15. List below all of the forms and supporting information that accompany this application (Include all I DAS
 forms, checklists, mandatory supporting information etc. that will be submitted as part of this application. Note: this
 question does not apply for applications made online using Smart eDA-)


 Description of attachment or title of attachment                                         Method of lodgement to
                                                                                          assessment manager


 Form 6

 Checklist




I 16.Applicant’s declaration

6                                                                                              IDAS form 1-Application details
                                                                                                Version 2.017 December 2012