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10/0406 - Operational Works - Jetty [As Published] · 142010.406

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QLEAVE NOTIFICATION AND PAYMENT (for completion by assessment manager or private certifier if applicable)

 

Date receipted :
form sighted by|Name of officer who
assessment __|sighted the form

manager

QLeave Project {Amount

Description of the work Number paid ($)

Date paid

 

 

 

 

 

 

 

 

 

 

The Sustainable Planning Act 2009 (SPA) is administered by the Department of Infrastructure and Planning. This
form and all other required application materials should be sent to your assessment manager and any referral
agencies.

 

Application Details - IDAS form 1
' Version 1.0 18 December 2009

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