IDAS form 1 · OPW12/0427

Table I        Lot on plan description for strategic port [and                  Port authority for the [ot




Tabte J        Name of local government for the tidal area (if appticabte)      Port authority for the tidal area (if applicable)




g. Are there any existing easements on the premises? (e.g. for vehicular access, electricity, overland flow, water, etc.)

A         No I       yes-ensure the type, location and dimension of each easement is included in the plans submitted




V         No I       yes-ensure the nature, location and dimension of proposed works are included in plans submitted


r3. ls the payment of a portabte long service leave levy applicabte to this application? (refer to notes at the end of this
form for more information)


 M        No-go to question r5         f]    Yes



 r4. Has the portable long service leave levy been paid? (refer to notes at the end of this form for more information)


 M No
 T yes-complete table         K and submit with this application the yetlow locaI government/private certifier's copy
          receipted Qleave form
                                                                                                                          of the




Table K         Amount paid                  Date paid              Qleave Proiect Number (6 digit number starting with A, B,
                                                                    E,LorP)




                                                                                                                                    of
 r5. Has the [oca[ government agreed to apply a superseded ptanning scheme to this apptication under section 96
 the Sustainable PlanningAct zooy'?


 V        No


 n        Yes-please provide details below


 Name of local government                             Date of written notice given    Reference number of written notice given
                                                      by tocal government             by local government (if applicable)




                                                                                               Version t.o tB December 2cog