DA Form 1

 

(oO 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: |

 

 

 

 

   

 
  

co) ACM ack Asy Ici ale Mt liota Tela MON sa ae) yen seSciea

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.

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

[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)

 

 

 

 

 

 

 

Df Material change of use [] Reconfiguring a lot C Operational work (1 Building work
b) What is the approval type? (tick only one box) :
Development permit oO Preliminary approval (] Preliminary approval that includes a variation approval
c) What is the level of assessment?
BitCode assessment U1 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):

 

Hole t stebles ech Wdm co walt tane.

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.

[X{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)

 

 

 
   

  
  
 

 

 

 

 

 

CJ Material change ofuse [] Reconfiguring a lot CJ Operational work 1 Building work

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

CJ Development permit C1 Preliminary approval L] Preliminary approval that includes a variation approval
c) What is the level of assessment?

LJ 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.

L] Relevant plans of the proposed development are attached to the development application
6.3) Additional aspects of development

C1 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
J Not required

 

 

    
  

  

   
 

 

 

Page 3
DA Form 1 — Development application details
Version 1.3— 28 September 2020