S233655 QLeave 125 Lake Macdonald Drive Lake Macdonald

Your Assessment Manager (Local Government or Private Certifier - Class A) will require a
copy of this form prior to the issue of a development/building permit.



CONTACT QLEAVE
Unit 1 62 Crockford St, Northgate Q 4013 | PO Box 315, Virginia BC Q 4014
Freecall 1800 803 481 | Email [email protected] | Web www.qleave.qld.gov.au



BUILDING AND CONSTRUCTION WORK COMPLETED
When your building and construction work reaches practical completion, you will be
required to submit your final costs and completion date to QLeave. To provide QLeave with
these details please complete the building and construction work completed form available
at www.qleave.qld.gov.au and send it to [email protected]



PAID
Receipt number               Date paid                    Amount paid

 56969832505                  15 Sep 2020 1:24:27 PM       $5,152.00