DAForm1_AttachmenttoEA.01_signed

                                                                                                       Application form
             Development application Form 1 - Application details—attachment for an
                                          application for an environmental authority

Note that where you are applying new ERAs, and your existing EA is an amalgamated EA, the application for
ERAs associated with the DA application will create a new EA for the new ERAs. In this case you may wish to
nominate a take effect date in the future which, post approval of this application, will provide you with enough
time to amalgamate your current and new EAs. Amalgamating your EAs prior to the take effect date of your new
EA will prevent you being required to pay the first annual fee for your new EA.
  Do you want the EA to take effect on the decision date, nominated date, or pending development approval?*

         Decision date             The take effect date will be the date of the decision.
         Nominated date            Details of nominated take effect date:

12. Nomination of site contact
An alternative contact nominated by the legal person which holds, or will in future hold, a relevant authority
issued by the department. The department may direct correspondence relating to actual or potential compliance
matters to the site contact.

                                                                                            No
Do you want to nominate a site contact?*
                                                                                            Yes, provide details below

Title*                         First Name*                     Surname*


Email Address*                                                                              Indicate if you want to receive
                                                                                            correspondence via email

Phone




13. Nomination of application contact
An alternative contact nominated by the legal person which has submitted, or will in future submit, applications
to be assessed by the department. All departmental correspondence relating to the assessment of applications
will be directed to the application contact, however, if the application results in the issuing of a relevant authority,
the relevant authority will be sent to the applicant.
Name or Position*
Lisa McKinnon
Primary Phone*
3831 6744
Secondary Phone


Email Address*
[email protected]




Page 9 of 12 • ESR/2015/1791 • Version 8.00 • Last reviewed: 12 AUG 2021            Department of Environment and Science