DA Form 1

DA Form 1 – Development application details
Approved form (version 1.3 effective 28 September 2020) made under section 282 of the Planning Act 2016.


This form must be used to make a development application involving code assessment or impact assessment,
except when applying for development involving only building work.
For a development application involving building work only, use DA Form 2 – Building work details.
For a development application involving building work associated with any other type of assessable development
(i.e. material change of use, operational work or reconfiguring a lot), use this form (DA Form 1) and parts 4 to 6 of
DA Form 2 – Building work details.
Unless stated otherwise, all parts of this form must be completed in full and all required supporting information must
accompany the development application.
One or more additional pages may be attached as a schedule to this development application if there is insufficient
space on the form to include all the necessary information.




Note:   All terms used in this form have the meaning given under the Planning Act 2016, the Planning Regulation 2017, or the Development
        Assessment Rules (DA Rules).



PART 1 – APPLICANT DETAILS

  1) Applicant details
  Applicant name(s) (individual or company full name)          Cameron and Jane Blake
  Contact name (only applicable for companies)                 C/- Adapt Town Planning + Development Management (Tiani
                                                               Boulton)
  Postal address (P.O. Box or street address)                  PO Box 7618
  Suburb                                                       Sippy Downs
  State                                                        QLD
  Postcode                                                     4556
  Country                                                      Australia
  Contact number                                               0404 924 160
  Email address (non-mandatory)                                [email protected]
  Mobile number (non-mandatory)
  Fax number (non-mandatory)
  Applicant’s reference number(s) (if applicable)              20210473

  2) Owner’s consent
  2.1) Is written consent of the owner required for this development application?
  ☒ Yes – the written consent of the owner(s) is attached to this development application
  ☐ No – proceed to 3)