Revised DA Form 1

 

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

EMR site identification:

C] 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.

CJ Yes — All easement locations, types and dimensions are included in plans submitted with this development

 

application

 

EXYNo
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)

 

 

CJ Material change of use CJ Reconfiguring a lot [XY Operational work CJ Building work
b) What is the approval type? (tick only one box)
Pet Development permit C1 Preliminary approval CJ Preliminary approval that includes

a variation approval

 

c) What is the level of assessment?
Xf Code assessment CJ 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). Toa renwwve «etree vob ws Positioned ED le
locate at Hoe Wer, hei ve way

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

(Xf 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)

 

 

 

LJ Material change of use C1 Reconfiguring a lot CJ Operational work ( Building work

b) What is the approval type? (tick only one box)

LJ Development permit (Preliminary approval (] Preliminary approval that includes a variation
approval

 

c) What is the level of assessment?
LJ Code assessment LJ 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.

CJ Relevant plans of the proposed development are attached to the development application

 

 

 

Page 3
DA Form 1 — Development Application details
Version 1.1— 22 JUNE 2018