Development Application part 1 of 2 - IDAS Forms - OPW13/0163

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                                                                   BSA Certificati
    Date of engagement   Name
                                                                   number




QLEAVE NOTIFICATION AND PAYMENT (For completion by assessment ma
applicable)

                                QLeave project       Amount paid
Description of the work                                                Date paid
                                number               ($)




The Sustainable Planning Act 2009 is administered by the Department of State De
Planning. This form and all other required application materials should be sent to
referral agencies.