DA Form 1 and Email with Photo and drawing - 9 Pines Ave, Lake Cooroibah

             Listed on the Environmental Management Register (EMR) under the Environmental Protection Act 1994

        EMR site identification:
             Listed on the Contaminated Land Register (CLR) under the Environmental Protection Act 1994

        CLR site identification:


        5) Are there any existing easements over the premises?
        Note: Easement uses vary throughout Queensland and are to be identified correctly and accurately. For further information on easements and
        how they may affect the proposed development, see DA Forms Guide,
             Yes - All easement locations, types and dimensions are included in plans submitted with this development
                  application
        13 No

     PART 3 - DEVELOPMENT DETAILS

     Section 1 - Aspects of development
        6.1) Provide details about the first development aspect
        a) What is the type of development? (tick only one box)
             Material change of use              Reconfiguring a lot              H Operational work                       Building work

        b) What is the approval type? (tick only one box)
        0 Development permit                     Preliminary approval             Q Preliminary approval that includes a variation approval

        c) What is the level of assessment?
        0 Code assessment                        Impact assessment (requirespublic notification)

        d) Provide a brief description of the proposal (e.g. 6 unit apartment building defined as multi-unit dwelling, reconfiguration of 1 lot into 3
             lots):                        Ay           0 Mscci AteO
                                                                                                      f 5T7
        e) Relevant plans
        Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms guide:
              Relevant plans.
             Relevant plans of the proposed development are attached to the development application
        6.2) Provide details about the second development aspect
        a) What is the type of development? (tick only one box)
              Material change of use             Reconfiguring a lot                  Operational work                     Building work

        b) What is the approval type? (tick only one box)
                                                                                                                                                             C\A
              Development permit                 Preliminary approval                 Preliminary approval that includes a variation approval

        c) What is the level of assessment?
             Code assessment                 O Impact assessment (requires public notification)

        d) Provide a brief description of the proposal (e.g. 6 unit apartment building defined as multi-unit dwelling, reconfiguration of 1 lot into 3
        lots)'.


       e) Relevant plans
       Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms Guide:
             Relevant plans.
              Relevant plans of the proposed development are attached to the development application

        6.3) Additional aspects of development
             Additional aspects of development are relevant to this development application and the details for these aspects
             that would be required under Part 3 Section 1 of this form have been attached to this development application
              Not required




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                                                                                                               DA Form 1 - Development application details
                                                                                                                         Version 1.3— 28 September 2020
Document Set ID: 22589826
Version: 1, Version Date: 20/09/2023