DA Form 1 - Development application details - Other change.pdf

 Decision under section 62 of the Transport Infrastructure Act 1994
 23.15) Does this development application involve new or changed access to a state-controlled road?
    Yes – this application will be taken to be an application for a decision under section 62 of the Transport
    Infrastructure Act 1994 (subject to the conditions in section 75 of the Transport Infrastructure Act 1994 being
    satisfied)
  No

 Walkable neighbourhoods assessment benchmarks under Schedule 12A of the Planning Regulation
 23.16) Does this development application involve reconfiguring a lot into 2 or more lots in certain residential zones
 (except rural residential zones), where at least one road is created or extended?
    Yes – Schedule 12A is applicable to the development application and the assessment benchmarks contained in
 schedule 12A have been considered
  No
 Note: See guidance materials at www.planning.dsdmip.qld.gov.au for further information.


PART 8 – CHECKLIST AND APPLICANT DECLARATION

 24) Development application checklist
 I have identified the assessment manager in question 15 and all relevant referral
 requirement(s) in question 17                                                                                         Yes
 Note: See the Planning Regulation 2017 for referral requirements
 If building work is associated with the proposed development, Parts 4 to 6 of DA Form 2 –                             Yes
 Building work details have been completed and attached to this development application
                                                                                                                         Not applicable
 Supporting information addressing any applicable assessment benchmarks is with the
 development application
 Note: This is a mandatory requirement and includes any relevant templates under question 23, a planning report
 and any technical reports required by the relevant categorising instruments (e.g. local government planning
                                                                                                                       Yes
 schemes, State Planning Policy, State Development Assessment Provisions). For further information, see DA
 Forms Guide: Planning Report Template.
 Relevant plans of the development are attached to this development application
 Note: Relevant plans are required to be submitted for all aspects of this development application. For further        Yes
 information, see DA Forms Guide: Relevant plans.
 The portable long service leave levy for QLeave has been paid, or will be paid before a                                 Yes
 development permit is issued (see 21)
                                                                                                                       Not applicable

 25) Applicant declaration
  By making this development application, I declare that all information in this development application is true and
    correct
  Where an email address is provided in Part 1 of this form, I consent to receive future electronic communications
     from the assessment manager and any referral agency for the development application where written information
     is required or permitted pursuant to sections 11 and 12 of the Electronic Transactions Act 2001
 Note: It is unlawful to intentionally provide false or misleading information.
 Privacy – Personal information collected in this form will be used by the assessment manager and/or chosen
 assessment manager, any relevant referral agency and/or building certifier (including any professional advisers
 which may be engaged by those entities) while processing, assessing and deciding the development application.
 All information relating to this development application may be available for inspection and purchase, and/or
 published on the assessment manager’s and/or referral agency’s website.
 Personal information will not be disclosed for a purpose unrelated to the Planning Act 2016, Planning
 Regulation 2017 and the DA Rules except where:




                                                                                                                                           Page 11
                                                                                                         DA Form 1 – Development application details
                                                                                                                  Version 1.3— 28 September 2020


[OCR of page images]
Decision under section 62 of the Transport Infrastructure Act 1994
23.15) Does this development application involve new or changed access to a state-controlled road?

LJ Yes — this application will be taken to be an application for a decision under section 62 of the Transport
Infrastructure Act 1994 (subject to the conditions in section 75 of the Transport Infrastructure Act 1994 being
satisfied)

1 No

Walkable neighbourhoods assessment benchmarks under Schedule 12A of the Planning Requlation

23.16) Does this development application involve reconfiguring a lot into 2 or more lots in certain residential zones
(except rural residential zones), where at least one road is created or extended?

LJ Yes — Schedule 12A is applicable to the development application and the assessment benchmarks contained in
schedule 12A have been considered

1 No

Note: See guidance materials at www.planning.dsdmip.gqid.gov.au for further information.

 

 

PART 8 — CHECKLIST AND APPLICANT DECLARATION

  

24) Development application checklist

| have identified the assessment manager in question 15 and all relevant referral
requirement(s) in question 17 M1 Yes
Note: See the Planning Regulation 2017 for referral requirements

If building work is associated with the proposed development, Parts 4 to 6 of DAForm2—- Wf ves
Building work details have been completed and attached to this development application

 

 

LJ Not applicable

 

Supporting information addressing any applicable assessment benchmarks is with the

development application

Note: This is a mandatory requirement and includes any relevant templates under question 23, a planning report vw Yes
and any technical reports required by the relevant categorising instruments (e.g. local government planning

schemes, State Planning Policy, State Development Assessment Provisions). For further information, see DA

Forms Guide: Planning Report Template.

Relevant plans of the development are attached to this development application

 

 

Note: Relevant plans are required to be submitted for all aspects of this development application. For further vi Yes
information, see DA Forms Guide: Relevant plans.
The portable long service leave levy for QLeave has been paid, or will be paid before a LC Yes

development permit is issued (see 27) M Not applicable

25) Applicant declaration

vi By making this development application, | declare that all information in this development application is true and
correct

 

lV] Where an email address is provided in Part 1 of this form, | consent to receive future electronic communications
from the assessment manager and any referral agency for the development application where written information
is required or permitted pursuant to sections 11 and 12 of the Electronic Transactions Act 2001

Note: It is unlawful to intentionally provide false or misleading information.

Privacy — Personal information collected in this form will be used by the assessment manager and/or chosen

assessment manager, any relevant referral agency and/or building certifier (including any professional advisers

which may be engaged by those entities) while processing, assessing and deciding the development application.

All information relating to this development application may be available for inspection and purchase, and/or

published on the assessment manager's and/or referral agency’s website.

Personal information will not be disclosed for a purpose unrelated to the Planning Act 2016, Planning

Regulation 2017 and the DA Rules except where:

 

 

 

 

Page 11
DA Form 1 — Development application details
Version 1.3— 28 September 2020