DAForm 1

 19) Information request under Part 3 of the DA Rules
    I agree to receive an information request if determined necessary for this development application
    I do not agree to accept an information request for this development application
 Note: By not agreeing to accept an information request I, the applicant, acknowledge:
 • that this development application will be assessed and decided based on the information provided when making this development application
   and the assessment manager and any referral agencies relevant to the development application are not obligated under the DA Rules to
   accept any additional information provided by the applicant for the development application unless agreed to by the relevant parties
 • Part 3 of the DA Rules will still apply if the application is an application listed under section 11.3 of the DA Rules.
 Further advice about information requests is contained in the DA Forms Guide.



PART 7 – FURTHER DETAILS
 20) Are there any associated development applications or current approvals? (e.g. a preliminary approval)
    Yes – provide details below or include details in a schedule to this development application
    No
 List of approval/development             Reference number                      Date                                  Assessment
 application references                                                                                               manager
    Approval
    Development application
    Approval
    Development application

 21) Has the portable long service leave levy been paid? (only applicable to development applications involving building work or
 operational work)
    Yes – a copy of the receipted QLeave form is attached to this development application
    No – I, the applicant will provide evidence that the portable long service leave levy has been paid before the
 assessment manager decides the development application. I acknowledge that the assessment manager may give
 a development approval only if I provide evidence that the portable long service leave levy has been paid
    Not applicable (e.g. building and construction work is less than $150,000 excluding GST)
 Amount paid                           Date paid (dd/mm/yy)                             QLeave levy number
 $ To be confirmed

 22) Is this development application in response to a show cause notice or required as a result of an enforcement
 notice?
    Yes – show cause or enforcement notice is attached
    No

 23) Further legislative requirements
 Environmentally relevant activities
 23.1) Is this development application also taken to be an application for an environmental authority for an
 Environmentally Relevant Activity (ERA) under section 115 of the Environmental Protection Act 1994?
    Yes – the required attachment (form ESR/2015/1791) for an application for an environmental authority
 accompanies this development application, and details are provided in the table below
    No
 Note: Application for an environmental authority can be found by searching “ESR/2015/1791” as a search term at www.qld.gov.au. An ERA
 requires an environmental authority to operate. See www.business.qld.gov.au for further information.
 Proposed ERA number:                                                          Proposed ERA threshold:
 Proposed ERA name:




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                                                                                                   DA Form 1 – Development Application details
                                                                                                                 Version 1.1— 22 JUNE 2018