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Forms 47 Wyuna Dve Noosaville · OPW17/0015

Attached to the e-mail Operational Works Application OPW17/0015.

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Department of Infrastructure, Local Government and Planning

IDAS form 1—Application details

(Sustainable Planning Act 2009 version 4.3 effective 5 December 2016)

This form must be used for ALL development applications.

You MUST complete ALL questions that are stated to be a mandatory requirement unless otherwise identified on this
form.

For all development applications, you must:

e complete this form (IDAS form 1—Application details)

e complete any other forms relevant to your application

e provide any mandatory supporting information identified on the forms as being required to accompany your
application.

Attach extra pages if there is insufficient space on this form.

All terms used on this form have the meaning given in the Sustainable Planning Act 2009 (SPA) or the Sustainable
Planning Regulation 2009.

This form and any other IDAS form relevant to your application must be used for development applications relating to
strategic port land and Brisbane core port land under the Transport Infrastructure Act 1994 and airport land under the
Airport Assets (Restructuring and Disposal) Act 2008. Whenever a planning scheme is mentioned, take it to mean land
use plan for the strategic port land, Brisbane core port land or airport land.

PLEASE NOTE: This form is not required to accompany requests for compliance assessment.

 

Mandatory requirements

 

 

 

Applicant details (Note: the applicant is the person responsible for making the application and need not be the owner
of the land. The applicant is responsible for ensuring the information provided on all IDAS application forms is correct.
Any development permit or preliminary approval that may be issued as a consequence of this application will be issued

 

 

 

 

 

 

to the applicant.) |
Name/s (individual or company name in full) AQUA PONTOONS PTY LTD

For companies, contact name MELISSA DYER

Postal address 12 FERNLEIGH COURT

 

 

 

Suburb CURRUMBIN

 

 

 

 

 

 

 

State QLD Postcode 4223
Country AUSTRALIA
Contact phone number 0417 683 818

 

 

Mobile number (non-mandatory requirement)

 

 

 

 

Fax number (non-mandatory requirement)

 

Queensland
overnment

 
Full text of the other 12 pages

Page 2

Department of Infrastructure, Local Government and Planning

 

 

Email address (non-mandatory requirement) [email protected]

 

 

Applicant’s reference number (non-mandatory Q3150
requirement)

 

 

 

1. What is the nature of the development proposed and what type of approval is being sought?

 

 

Table A—Aspect 1 of the application (If there are additional aspects to the application please list in Table B—Aspect 2.)

 

a) Whatis the nature of the development? (Please only tick one box.)

C Material change of use | Reconfiguring a lot C Building work ra Operational work

b) What is the approval type? (Please only tick one box.)

Ol Preliminary approval oO Preliminary approval [WT Development permit
under s241 of SPA under s241 and s242
of SPA

c) Provide a brief description of the proposal, including use definition and number of buildings or structures where
applicable (e.g. six unit apartment building defined as a multi-unit dwelling, 30 lot residential subdivision etc.)

CONSTRUCT A NEW PONTOON STRUCTURE.

 

 

 

d) | Whatis the level of assessment? (Please only tick one box.)

C] Impact assessment [7 code assessment

 

 

Table B—Aspect 2 of the application (If there are additional aspects to the application please list in Table C—
Additional aspects of the application.)

 

 

a) Whatis the nature of development? (Please only tick one box.)
LI Material change of use CL Reconfiguring a lot oO Building work (_] Operational work

b) Whatis the approval type? (Please only tick one box.)

C Preliminary approval C Preliminary approval | Development
under s241 of SPA under s241 and s242 permit
of SPA

c) Provide a brief description of the proposal, including use definition and number of buildings or structures where
applicable (e.g. six unit apartment building defined as a multi-unit dwelling, 30 lot residential subdivision etc.)

 

 

 

 

d) Whatis the level of assessment?

CL Impact assessment | Code assessment

 

 

Table C—Additional aspects of the application (|f there are additional aspects to the application please list ina
separate table on an extra page and attach to this form.)

C Refer attached schedule iw Not required

 

 

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

Page 3

Department of Infrastructure, Local Government and Planning

 

 

2. Location of the premises (Complete Table D and/or Table E as applicable. Identify each lot in a separate row.)

 

 

Table D—Street address and lot on plan for the premises or street address and lot on plan for the land adjoining or
adjacent to the premises (Note: this table is to be used for applications involving taking or interfering with water.)
(Attach a separate schedule if there is insufficient space in this table.)

 

LE] Street address and lot on plan (All lots must be listed.)

WW Street address and lot on plan for the land adjoining or adjacent to the premises (Appropriate for
development in water but adjoining or adjacent to land, e.g. jetty, pontoon. All lots must be listed.)

 

 

 

 

 

Street address Lot on plan description | Local government area
Lot Unit Street | Street name and official suburb/ Post- | Lotno. | Plan type (e.g. Logan, Cairns)
no. no. locality name code and plan no.
i) 47 WYUNA DRIVE, 4566 | 23 N10575 NOOSA COUNCIL
NOOSAVILLE, QLD
ii)
iii)

 

 

 

 

 

 

 

Planning scheme details (If the premises involves multiple zones, clearly identify the relevant zone/s for each lot in a
separate row in the below table. Non-mandatory)

 

Lot Applicable zone / precinct Applicable local plan / precinct Applicable overlay/s

 

i)
ii)

il)

 

 

 

 

 

 

 

Table E—Premises coordinates (Appropriate for development in remote areas, over part of a lot or in water not
adjoining or adjacent to land e.g. channel dredging in Moreton Bay.) (Attach a separate schedule if there is insufficient
space in this table.)

 

 

 

Coordinates Zone Datum Local government
(Note: place each set of coordinates in a separate row) reference area (if applicable)
Easting Northing Latitude Longitude

L] Gpas4

L] wess4

L other

 

 

 

 

 

 

 

 

3. Total area of land on which the development is proposed (indicate square metres)

 

 

612 sqm |

 

 

4. Current use/s of the premises (e.g. vacant land, house, apartment building, cane farm etc.)

 

 

 

PRIVATE RESIDENCE

 

 

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

Page 4

Department of Infrastructure, Local Government and Planning

 

 

5. Are there any current approvals (e.g. a preliminary approval) associated with this application? (Non-
mandatory requirement)

 

w No [] Yes—provide details below

 

List of approval reference/s Date approved (dd/mm/yy) Date approval lapses (dd/mm/yy)

 

 

 

 

 

6. Is owner’s consent required for this application? (Refer to notes at the end of this form for more information.)

[_]_ No

[1 Yes—complete either Table F, Table G or Table H as applicable

 

 

 

 

Table F

 

Name of owner/s of the land

 

\We, the above-mentioned owner/s of the land, consent to the making of this application.

 

Signature of owner/s of the land

Date pal

Table G

 

 

 

 

Name of owner/s of the land Jacqueline Melanie MARR & State

 

Iw The owner's written consent is attached or will be provided separately to the assessment manager.

 

 

Table H

 

Name of owner/s of the land

 

 

 

Cl By making this application, |, the applicant, declare that the owner has given written consent to the making of the application.

 

 

Identify if any of the following apply to the premises (Tick applicable box/es.)

 

fae]
ae

Adjacent to a water body, watercourse or aquifer (e.g. creek, river, lake, canal)—complete Table |

On strategic port land under the Transport Infrastructure Act 1994—complete Table J

In a tidal water area—complete Table K

On Brisbane core port land under the Transport Infrastructure Act 1994 (No table requires completion.)

On airport land under the Airport Assets (Restructuring and Disposal) Act 2008 (no table requires completion)

Listed on either the Contaminated Land Register (CLR) or the Environmental Management Register (EMR) under
the Environmental Protection Act 1994 (no table requires completion)

OOOROR

 

 

Table |
Name of water body, watercourse or aquifer
| WEYBA CREEK

 

 

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

Page 5

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)

NOOSA COUNCIL

 

 

 

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

 

IM No L] Yes—ensure the type, location and dimension of each easement is included in the plans submitted

 

©

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

 

EC No ! Yes—ensure the nature, location and dimension of proposed works are included in plans submitted

 

40. 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.)

 

4 No—go to question 11 [] Yes

 

 

 

40a. Has the portable long service leave levy been paid? (Refer to notes at the end of this form for more
information.)

 

 

[-] No

CI Yes—complete 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/mm/yy) starting with A, B, E, L, P or S)

 

 

 

 

 

 

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

 

 

IW No

Cl 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/mm/yy)

 

 

 

 

 

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

Page 6

Department of Infrastructure, Local Government and Planning

 

42. List below all of the forms and supporting information that accompany this application (Include all IDAS

forms, checklists, mandatory supporting information etc. that will be submitted as part of this application)

 

 

 

 

 

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

IDAS Form 23, Form 15 EMAIL

DSDIP Concurrence, DEHP Owners Consent, Title Search, Client authority EMAIL

Plans EMAIL

 

 

 

 

 

13. Applicant’s declaration

 

 

 

[Vf By making this application, | declare that all information in this application is true and correct (Note: it is unlawful to
provide false or misleading information)

 

 

Notes for completing this form

e

Section 261 of the Sustainable Planning Act 2009 prescribes when an application is a properly-made application.
Note, the assessment manager has discretion to accept an application as properly made despite any non-
compliance with the requirement to provide mandatory supporting information under section 260(1)(c) of the
Sustainable Planning Act 2009

Applicant details

Where the applicant is not a natural person, ensure the applicant entity is a real legal entity.

Question 1

Schedule 3 of the Sustainable Planning Regulation 2009 identifies assessable development and the type of
assessment. Where schedule 3 identifies assessable development as “various aspects of development’ the
applicant must identify each aspect of the development on Tables A, B and C respectively and as required.

Question 6

Section 263 of the Sustainable Planning Act 2009 sets out when the consent of the owner of the land is required for
an application. Section 260(1)(e) of the Sustainable Planning Act 2009 provides that if the owner’s consent is
required under section 263, then an application must contain, or be accompanied by, the written consent of the
owner, or include a declaration by the applicant that the owner has given written consent to the making of the
application. If a development application relates to a state resource, the application is not required to be supported
by evidence of an allocation or entitlement to a state resource. However, where the state is the owner of the
subject land, the written consent of the state, as landowner, may be required. Allocation or entitlement to the state
resource is a separate process and will need to be obtained before development commences.

Question 7

If the premises is listed on either the Contaminated Land Register (CLR) or the Environmental
Management Register (EMR) under the Environmental Protection Act 1994 it may be necessary to
seek compliance assessment. Schedule 18 of the Sustainable Planning Regulation 2009 identifies
where compliance assessment is required.

Question 10

The Building and Construction Industry (Portable Long Service Leave) Act 1991 prescribes when the portable long
service leave levy is payable.

The portable long service leave levy amount and other prescribed percentages and rates for calculating the levy
are prescribed in the Building and Construction Industry (Portable Long Service Leave) Regulation 2013.

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

Page 7

Department of Infrastructure, Local Government and Planning

Question 10a

e The portable long service leave levy need not be paid when the application is made, but the Building and
Construction Industry (Portable Long Service Leave) Act 1991 requires the levy to be paid before a development
permit is issued.

e Building and construction industry notification and payment forms can be completed on the QLeave website at
www.qleave.qid.gov.au. For further information contact QLeave on 1800 803 481.

Privacy—the information collected in this form will be used by the Department of Infrastructure, Local Government
and Planning (DILGP), assessment manager, referral agency and/or building certifier in accordance with the
processing and assessment of your application. Your personal details should not be disclosed for a purpose outside of
the IDAS process or the provisions about public access to planning and development information in the Sustainable
Planning Act 2009, except where required by legislation (including the Right to Information Act 2009) or as required by
Parliament. This information may be stored in relevant databases. The information collected will be retained as
required by the Public Records Act 2002.

 

OFFICE USE ONLY

 

 

Date received Reference numbers

 

 

 

 

 

NOTIFICATION OF ENGAGEMENT OF A PRIVATE CERTIFIER

 

To Council. | have been engaged as the private certifier for the
building work referred to in this application

 

 

 

 

BSA Certification license Building

Date of engagement | Name number classification/s

 

 

 

 

 

 

 

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

 

Date receipted Name of officer

* a QLeave project Amount paid ; form sighted by .
Description of the work warmber (3) Date paid assecement ba sighted the
manager

 

 

 

 

 

 

 

 

 

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 1—Application details
Version 4.3—5 December 2016

Page 8

Department of Infrastructure, Local Government and Planning

 

 

IDAS form 23-1 lal.

(Sustainable Planning Act 2009 version 3.1 effective 3 August 2015)

This form must be used for development applications for:

e operational work that is tidal works (including prescribed tidal works) or operational work within the coastal
management district (mentioned in the Sustainable Planning Regulation 2009, schedule 7, table 2, item 13)

e material change of use that requires referral under the Sustainable Planning Regulation 2009, schedule 7, table 3,
item 5 because it involves:

- operational work carried out completely or partly in the coastal management district; or

- building work carried out completely or partly in the coastal management district that is the construction of a
new premises with a gross floor area (GFA) of at least 1000m? or the enlargement of the GFA of an existing
premises by more than 1000m?

e reconfiguring a lot that requires referral under the Sustainable Planning Regulation 2009, schedule 7, table 2, item
14 because the land is situated completely or partly in the coastal management district or the reconfiguration is in
connection with the construction of a canal

e building work that requires referral under the Sustainable Planning Regulation 2009, schedule 7, table 1, item 11
because it is on land completely or partly seaward of a coastal building line.

You MUST complete ALL questions that are stated to be a mandatory requirement unless otherwise identified on this
form.

Notes for completing this form

For all development applications you must:

e complete DAS form 1—Application details

e complete any other forms relevant to your application

e provide any mandatory supporting information identified on the forms as being required to accompany your
application.

Attach extra pages if there is insufficient space on this form.

All terms used on this form have the meaning given in the Coastal Management and Protection Act 1995, the Coastal
Protection and Management Regulation 2003, the Sustainable Planning Act 2009 (SPA) or the Sustainable Planning
Regulation 2009.

 

| Mandatory requirements |

 

 

1. Confirm the following mandatory requirements accompany Confirmation of Method of
this application lodgement lodgement

 

 

Written description of the proposal, including a report that addresses any [IY Confirmed
relevant policies.

 

 

 

 

 

[2. What is the nature of the work or development proposed by the application? (Tick all applicable boxes.)

 

“1 Operational work—complete table A LC Material Change of Use—complete table B
| Reconfiguring a Lot—complete table Cc LC] Building Work—complete table D

 

 

Queensland
Government

Page 9

Department of Infrastructure, Local Government and Planning

 

 

 

Table A—Operational Work

 

Does the operational work involve the following? (Tick all applicable boxes.)

a) Tidal works as defined under the Coastal Protection and Management Act 1995 (e.g. basins, breakwater, bridges,
boat ramps, decks and boardwalks, docks, dockyards, groynes, jetties, marinas, pipelines, pontoons, powerlines,
seawalls, slips, training walls, wharves and the reclamation of land under tidal water)?

C No [Yes

If yes, what is the purpose?
[ CONSTRUCT A NEW PONTOON STRUCTURE TO REPLACE OLD PONTOON. |

 

 

wy Private purpose (e.g. private pontoon)
[_] Another purpose (e.g. commercial marina)

Does the tidal works also require resource allocation under the Coastal Protection and Management Act 1995?

[J No C] Yes

If applicable what is the estimated value of the proposed works?

 

 

 

 

b) Interfering with quarry material as defined under the Coastal Protection and Management Act 1995 (e.g.
excavating or moving sand, gravel or any other earth material on state coastal land such as roads, esplanades,
parks or unallocated state land) on state coastal land above high-water mark.

ra) No LE] Yes
If yes, which of the following?

CJ Works for coastal management purpose involving beach nourishment, dune fencing, revegetation of dunal areas
with endemic native plants, or stinger net enclosures.

CL For purposes directly related to the provision of lifesaving or rescue services by a volunteer community
organisation.

[] For other purposes (please state below).

L i

If applicable what is the estimated value of the proposed works?

L |

c) Disposing of dredge spoil or other solid waste material in tidal water?
No L] Yes
If applicable what is the estimated value of the proposed works?

 

 

 

d) Constructing an artificial waterway?

I No LI Yes

If applicable what is the length of the waterway?

e) Removing or interfering with coastal dunes on land, other than state coastal land, that is in an erosion prone area
as defined in the Coastal Protection and Management Act 1995 and above high water mark (e.g. lowering dune
vegetation on freehold and leasehold land)?

No O Yes

If applicable what is the estimated value of the proposed works?

 

 

 

IDAS form 23

 

Page 10

Department of Infrastructure, Local Government and Planning

 

 

—q
Table B—Material change of use

 

a) Does the material change of use involve the following? (Tick all applicable boxes.)
C Operational work carried out completely or partly in the coastal management district

b) Does the material change of use involve building work carried out completely or partly in the coastal management
district that is:

[_] the construction of new premises with a gross floor area of at least 1000 m?
CL the enlargement of the gross floor area of existing premises by more than 1000 m?

 

 

Table C—Reconfiguring a lot

 

a) Does the reconfiguring a lot involve the following? (Tick all applicable boxes.)
| Land situated completely or partly in the coastal management district

LE] The construction of a canal
b) How many lots will be created?

 

 

 

 

 

 

| Table D—Building work

a) _ Is the building work on land completely or partly seaward of the coastal building line under the Coastal Protection
and Management Act 1995?

[Wf No [_] Yes

3. Is the tidal works located within a local government tidal area? (Tick all applicable boxes) |
CL] No [WI Yes—provide details below

 

 

 

 

 

 

 

| Local government: | NOOSA SHIRE COUNCIL

 

 

 

Mandatory supporting information

 

 

 

 

 

 

 

4. Please provide the following information Confirmation of Method of
lodgement lodgement

For all applications

A statement addressing the relevant part(s) of the State Development LC Confirmed

Assessment Provisions (SDAP). LI Not applicable

For applications involving operational work that is tidal works

A copy of the certificate of title for the land (including tidal land) that iv] Confirmed

would abut or adjoin the proposed works. [| Not applicable

Plans showing: [7] Confirmed

e the real property description and boundaries of the land (including [_] Not applicable
tidal land) that would abut or adjoin the proposed works

e the proposed works (including existing works to be removed) in
relation to relevant tidal planes (e.g. mean high water springs)

e the slope angles of the beds and banks of the tidal area and the
finished levels of the proposed works.

 

For tidal work that will occupy a navigable waterway provide a water rf Confirmed
allocation area plan providing evidence that the proposed work will not LE] Not applicable
prejudice the access rights of adjoining property owners.

 

 

 

 

 

IDAS form 23—

Page 11

Department of Infrastructure, Local Government and Planning

 

 

Details of the largest vessel, if any, to be moored at the structure. “ Confirmed
LC Not applicable
For prescribed tidal works, details of how the proposed work addresses [yy Confirmed

the IDAS code for prescribed tidal work in the Coastal Protection and Not applicable
Management Regulation 2003, schedule 4A. O RP

 

 

If applicable, certification that the design of tidal works is suitable for Confirmed
intended use, signed by a Registered Professional Engineer of ;
Queensland (or equivalent). LU heb applcane

 

For applications involving material change of use

 

Plans certified by a registered professional engineer of Queensland CE Confirmed

(RPEQ) or a registered surveyor showing: Ivy Not applicable

e the real property description and boundaries of the land

e 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 [4 Not applicable
e The location of the coastal management district and coastal hazards
in relation to the land being reconfigured
e 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 LE] Confirmed
(RPEQ): Not applicable
e the real property description and boundaries of the land

e the proposed works in relation to the location of the coastal building

line. |

Notes for completing this form

e Please ensure all applicable fees are paid, noting that referral agency fees are to be paid to the Department of
Environment and Heritage Protection.

e Foran 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—Tide

      

Page 12

   

Version 3 a March 2013

Form 15—Compliance Certificate for building Design or Specification

 

NOTE

This is to be used for the purposes of section 10 of the Building Act 1975 andlor section 46 of the
Building Regulation 2006.

RESTRICTION: A building certifier (class B) can only give a compliance certificate about whether
building work complies with the BCA or a provision of the QDC. A building certifier (Class B) can
not give a certificate regarding QDC boundary clearance and site cover provisions.

 

1, Property description

This section need only be completed if
details of street address and property
description are applicable.

EG. in the case of (standard/generic)
pool design/shell manufacture and/or
patio and carport systems this section
may not be applicable.

The description must identify alt land the
‘subject of the application.

The lot & plan details {eg. SP / RP) are
shown on title documents or a rates notice.
lf the plan Is not registered by title, provide
previous fot and plan details.

2. Description of componentis certified
Clearly describe the extent of work covered by
this certificate, e.g, all structural aspects of the
steel roof beams.

Street address (include no., street suburb / locality & postcode}
41 WYUNA ORWE
NOOSAVILLE

Lot & plan details (attach list if necessary)

 

 

Postcode

 

 

In which local government area is the land situated?

 

 

 

 

 

 

EXISTING RESIDENCE
NEW PONTOON AND GANG WAY

 

 

 

 

 

 

 

 

 

3. Basis of certification

Detall the basis for giving the certificate and the
extent to which tests, specifications, rules,
standards, codes of practice and other
publications, were relied upon.

STRUCT
DESIGN

L. ENGI
AILS

EERIN
ND SPECIFICAT!

S kuc IN

LN

 

 

4, Reference documentation
Clearly identify any relevant documentation,
€.g. numbered structural engineering plans.

 

STRUCTURAL ENGINEERING

 

DESIGN DRAWINGS NUMBERED *

 

APSI50 —— SHEETS Of To O04

 

 

 

 

 

 

 

 

 

 

LOCAL GOVERNMENT USE ONLY

Cot ad

 

   

 

 

The Building Act 1975 is administered by the
Department of Housing and Public Works

Queensland
Government

 

 

Page 13

 

 

§, Building certifier reference number

Building certifier reference number

 

 

 

 

 

6. Competent person details

A competent person for building work, means a
person who is assessed by the building certifier
for the work as competent to practise in an
aspect of the building and specification design,
of the building work because of the individual's
skill, experience and qualifications in the
aspect. The competent person must also be
registered or ticensed under a law applying in
the State to practice the aspect.

If no relevant law requires the individual to be
licensed or registered to be able to give the
help, the certifier must assess the individual as
having appropriate experience, qualifications or

Name (in full

MARK WICHLINSKI |

 

 

 

 

 

 

 

Company name (if applicable) Contact person

MARK WICHLINGICI

CONSULTING PROINEKERS PTY Lip MARK WICHLINSK)
Phone no, business hours Mobile no, Fax no.

 

[ (ss) 3eze4e |

 

(oa4i2) IS 002

 

| (35) 382646 |

 

Email address

|

Postal address

|

 

 

 

 

 

 

 

 

skills to be able to give the help. PRO. BOX 6297
If the chief executive issues any guidelines for
assessing a competent person, the building G 0 LD COAST MA \ L. CENTRE pasta Qt 1 26
certiler must use the guidelines when Licence or registration number (if applicable)
assessing the person.
RPEQ N? 1643
7. Signature of competent person Signature \ Date
This certificate must be signed by the individual o * 6
assessed by the building certifier as competent. ARO) Ww elie Zi. V - \§

 

 

 

 

 

 

 

 

 

 

The Building Act 1975 is administered by the
Department of Housing and Public Works

Queensland
Government

 

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