Approved forms under the Planning Act 2016 · Summary of approved forms . Form name Requirement...

Approved forms under the Planning Act 2016 2 June 2017

All approved forms will be available from 3 July 2017 in Word format. If you wish to access this before then, please contact the department at [email protected]

Summary of approved forms

Form name Requirement Form identifier and version

Public notice about a decision not to amend or replace a planning scheme

Section 25(2) of the Planning Act requires that a local government publish a public notice, in the approved form, where it has made a decision not to amend or replace its planning scheme after undertaking a review of the scheme under section 25(1).

Planning Act Form 1 (version 1.0)

Approved forms for making a development application

When making a development application, section 51(1)(a) of the Planning Act requires that the development application be made in the approved form to the assessment manager. Two forms are proposed:

DA Form 1 for general development applications

DA Form 2 only for development applications involving building works.

DA Form 1 (version 1.0)

DA Form 2 (version 1.0)

Notice of decision (approval)

Notice of decision (refusal)

Section 63(2) of the Planning Act requires that a decision notice be in the approved form and include the content required under this provision. Two separate forms are proposed:

development applications which are approved

development applications which are refused.

Planning Act Form 2 (version 1.0) Planning Act Form 3 (version 1.0)

Deemed approval notice Where an applicant chooses to call on the deemed approval provisions under section 64 of the Planning Act, they must in accordance with section 64(3) give a deemed approval notice, in the approved form to the assessment manager.


Change application form The Local Government Electoral (Transparency and Accountability in Local Government) and Other Legislation Amendment Act amends section 79 of the Planning Act to require that a change application be made in the approved form.


LGIP review checklist form

Appointed reviewer statement template form

The Ministers Guidelines and Rules (MGR) establish two approved forms in the Local Government Infrastructure Plan (LGIP) chapter. The checklist includes information completed by the local government and appointed reviewer about how an LGIP addresses the requirements of the LGIP Guideline. The appointed reviewer statement summarises an appointed reviewer’s findings about an LGIP review undertaken.

MGR5.1 (version 1.0)

MGR5.2 (version 1.0)

The Planning Act 2016 is administered by the Department of Infrastructure, Local Government and Planning, Queensland Government.

Planning Act Form 1 – Public notice about a decision not to amend or replace a planning scheme Version 1.0—3 July 2017

Public Notice Decision not to amend or replace the [insert name of planning scheme] Planning Act Form 1 (version 1.0 effective 3 July 2017) made under Section 282 of the Planning Act 2016 for a public notice under s25(2) of the Planning Act 2016.

Pursuant to section 25(1) of the Planning Act 2016, [insert local government name] has undertaken a review of the [insert name of planning scheme] (being its planning scheme) and based on that review, on [insert date of decision] has decided not to amend or replace this planning scheme.

The reasons for this decision are:

[list reasons for decision]

For further information about this decision, please contact [insert local government contact phone number], [insert local government contact email address] or [insert local government website].

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This form and any other form relevant to the development application must be used to make a development application relating to strategic port land and Brisbane core port land under the Transport Infrastructure Act 1994, and airport land under the Airport Assets (Restructuring and Disposal) Act 2008. For the purpose of assessing a development application relating to strategic port land and Brisbane core port land, any reference to a planning scheme is taken to mean a land use plan for the strategic port land, Brisbane port land use plan for Brisbane core port land, or a land use plan for airport land.

DA Form 1 – Development application details Approved form (version 1.0 effective 3 July 2017) 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 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, 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)

Contact name (only applicable for companies)

Postal address (P.O. Box or street address)

Suburb

State

Postcode

Country

Contact number

Email address (non-mandatory)

Mobile number (non-mandatory)

Fax number (non-mandatory)

Applicant’s reference number(s) (if applicable)

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)

DA Form 1 – Development Application details

Version 1.0—3 July 2017

PART 2 – LOCATION DETAILS

3) Location of the premises (complete 3.1) or 3.2), and 3.3) as applicable)

Note: Provide details below and attach a site plan for any or all premises part of the development application. For further information, see DA Forms Guide: Relevant plans.

3.1) Street address and lot on plan

Street address AND lot on plan (all lots must be listed), or

Street address AND lot on plan for an adjoining or adjacent property of the premises (appropriate for development in water

but adjoining or adjacent to land e.g. jetty, pontoon; all lots must be listed).

a)

Unit No. Street No. Street Name and Type Suburb

Postcode Lot No. Plan Type and Number (e.g. RP, SP) Local Government Area(s)

b)



3.2) Coordinates of premises (appropriate for development in remote areas, over part of a lot or in water not adjoining or adjacent to land e.g.

channel dredging in Moreton Bay)

Note: Place each set of coordinates in a separate row. Only one set of coordinates is required for this part.

Coordinates of premises by longitude and latitude

Longitude(s) Latitude(s) Datum Local Government Area(s) (if applicable)

WGS84

GDA94

Other:

Coordinates of premises by easting and northing

Easting(s) Northing(s) Zone Ref. Datum Local Government Area(s) (if applicable)

54

55

56

WGS84

GDA94

Other:

3.3) Additional premises

Additional premises are relevant to this development application and their details have been attached in a schedule to this application

Not required

4) Identify any of the following that apply to the premises and provide any relevant details

In or adjacent to a water body or watercourse or in or above an aquifer

Name of water body, watercourse or aquifer:

On strategic port land under the Transport Infrastructure Act 1994

Lot on plan description of strategic port land:

Name of port authority for the lot:

In a tidal area

Name of local government for the tidal area (if applicable):

Name of port authority for tidal area (if applicable):

On airport land under the Airport Assets (Restructuring and Disposal) Act 2008

Name of airport:

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:

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.

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)

Material change of use Reconfiguring a lot Operational work Building work

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

Development permit Preliminary approval Preliminary approval that includes

a variation approval

c) What is the level of assessment?

Code assessment 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 plansNote: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms guide: Relevant plans.

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)

Material change of use Reconfiguring a lot Operational work Building work

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

Development permit Preliminary approval Preliminary approval that includes a variation approval

c) What is the level of assessment?

Code assessment 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 plansNote: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms Guide: Relevant plans.

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

6.3) Additional aspects of development

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

Not required



Section 2 – Further development details 7) Does the proposed development application involve any of the following?

Material change of use Yes – complete division 1 if assessable against a local planning instrument

Reconfiguring a lot Yes – complete division 2

Operational work Yes – complete division 3

Building work Yes – complete DA Form 2 – Building work details

Division 1 – Material change of use Note: This division is only required to be completed if any part of the development application involves a material change of use assessable against a local planning instrument.

8.1) Describe the proposed material change of use

Provide a general description of the proposed use

Provide the planning scheme definition (include each definition in a new row)

Number of dwelling units (if applicable)

Gross floor area (m

2)

(if applicable)

8.2) Does the proposed use involve the use of existing buildings on the premises?

Yes

No

Division 2 – Reconfiguring a lot Note: This division is only required to be completed if any part of the development application involves reconfiguring a lot.

9.1) What is the total number of existing lots making up the premises?

9.2) What is the nature of the lot reconfiguration? (tick all applicable boxes)

Subdivision (complete 10)) Dividing land into parts by agreement (complete 11))

Boundary realignment (complete 12)) Creating or changing an easement giving access to a lot from a construction road (complete 13))

10) Subdivision

10.1) For this development, how many lots are being created and what is the intended use of those lots:

Intended use of lots created Residential Commercial Industrial Other, please specify:

Number of lots created

10.2) Will the subdivision be staged?

Yes – provide additional details below

No

How many stages will the works include?

What stage(s) will this development application apply to?

11) Dividing land into parts by agreement – how many parts are being created and what is the intended use of theparts?

Intended use of parts created Residential Commercial Industrial Other, please specify:

Number of parts created



12) Boundary realignment

12.1) What are the current and proposed areas for each lot comprising the premises?

Current lot Proposed lot

Lot on plan description Area (m2) Lot on plan description Area (m

2)

12.2) What is the reason for the boundary realignment?

13) What are the dimensions and nature of any existing easements being changed and/or any proposed easement?(attach schedule if there are more than two easements)

Existing or proposed?

Width (m) Length (m) Purpose of the easement? (e.g.

pedestrian access) Identify the land/lot(s) benefitted by the easement

Division 3 – Operational work Note: This division is only required to be completed if any part of the development application involves operational work.

14.1) What is the nature of the operational work?

Road work

Drainage work

Landscaping

Stormwater

Earthworks

Signage

Water infrastructure

Sewage infrastructure

Clearing vegetation

Other – please specify:

14.2) Is the operational work necessary to facilitate the creation of new lots? (e.g. subdivision)

Yes – specify number of new lots:

No

14.3) What is the monetary value of the proposed operational work? (include GST, materials and labour)

$

PART 4 – ASSESSMENT MANAGER DETAILS

15) Identify the assessment manager(s) who will be assessing this development application

16) Has the local government agreed to apply a superseded planning scheme for this development application?

Yes – a copy of the decision notice is attached to this development application

Local government is taken to have agreed to the superseded planning scheme request – relevant documents attached

No

PART 5 – REFERRAL DETAILS

17) Do any aspects of the proposed development require referral for any referral requirements?Note: A development application will require referral if prescribed by the Planning Regulation 2017.

No, there are no referral requirements relevant to any development aspects identified in this development application – proceed to Part 6

Matters requiring referral to the chief executive of the Planning Regulation 2017:

Clearing native vegetation

Contaminated land (unexploded ordnance)



Environmentally relevant activities (ERA) (only if the ERA have not been devolved to a local government)

Fisheries – aquaculture

Fisheries – declared fish habitat area

Fisheries – marine plants

Fisheries – waterway barrier works

Hazardous chemical facilities

Queensland heritage place (on or near a Queensland heritage place)

Infrastructure – designated premises

Infrastructure – state transport infrastructure

Infrastructure – state transport corridors and future state transport corridors

Infrastructure – state-controlled transport tunnels and future state-controlled transport tunnels

Infrastructure – state-controlled roads

Land within Port of Brisbane’s port limits

SEQ development area

SEQ regional landscape and rural production area or SEQ Rural living area – community activity

SEQ regional landscape and rural production area or SEQ Rural living area – indoor recreation

SEQ regional landscape and rural production area or SEQ Rural living area – residential development

SEQ regional landscape and rural production area or SEQ Rural living area – urban activity

Tidal works or works in a coastal management district

Urban design

Water-related development – taking or interfering with water

Water-related development – removing quarry material (from a watercourse or lake)

Water-related development – referable dams

Water-related development – construction of new levees or modification of existing levees (category 2 or 3 levees only)

Wetland protection area

Matters requiring referral to the local government:

Airport land

Environmentally relevant activities (ERA) (only if the ERA have been devolved to local government)

Local heritage places

Matters requiring referral to the chief executive of the distribution entity or transmission entity:

Electricity infrastructure

Matters requiring referral to:

The chief executive of the holder of the licence, if not an individual

The holder of the licence, if the holder of the licence is an individual

Oil and gas infrastructure

Matters requiring referral to the Brisbane City Council:

Brisbane core port land

Matters requiring referral to the Minister under the Transport Infrastructure Act 1994:

Brisbane core port land

Strategic port land

Matters requiring referral to the relevant port operator:

Brisbane core port land (below high-water mark and within port limits)

Matters requiring referral to the chief executive of the relevant port authority:

Land within limits of another port

Matters requiring referral to the Gold Coast Waterways Authority:

Tidal works, or development in a coastal management district in Gold Coast waters

Matters requiring referral to the Queensland Fire and Emergency Service:

Tidal works, or development in a coastal management district



18) Has any referral agency provided a referral response for this development application?

Yes – referral response(s) received and listed below are attached to this development application

No

Referral requirement Referral agency Date of referral response

Identify and describe any changes made to the proposed development application that was the subject of the referral response and the development application the subject of this form, or include details in a schedule to this development application (if applicable).

PART 6 – INFORMATION REQUEST

19) Information request under Part 3 of the DA Rules

I agree to receive an information request if determined necessary for this development application

I do not agree to accept an information request for this development application Note: By not agreeing to accept an information request I, the applicant, acknowledge:

that this development application will be assessed and decided based on the information provided when making this development application andthe assessment manager and any referral agencies relevant to the development application are not obligated under the DA Rules to accept any additional information provided by the applicant for the development application unless agreed to by the relevant parties

Part 3 of the DA Rules will still apply if the application is an application listed under section 11.3 of the DA Rules.

Further advice about information requests is contained in the DA Forms Guide.

PART 7 – FURTHER DETAILS

20) Are there any associated development applications or current approvals? (e.g. a preliminary approval)

Yes – provide details below or include details in a schedule to this development application

No

List of approval/development application references

Reference number Date Assessment manager

Approval

Development application

Approval


21) Has the portable long service leave levy been paid? (only applicable to development applications involving building work or

operational work)

Yes – the yellow local government/private certifier’s copy of the receipted QLeave form is attached to this development application

No – I, the applicant will provide evidence that the portable long service leave levy has been paid before the assessment manager decides the development application. I acknowledge that the assessment manager may give a development approval only if I provide evidence that the portable long service leave levy has been paid

Not applicable

Amount paid Date paid (dd/mm/yy) QLeave levy number (A, B or E)

$

22) Is this development application in response to a show cause notice or required as a result of an enforcement notice?

Yes – show cause or enforcement notice is attached

No



23) Further legislative requirements

Environmentally relevant activities

23.1) Is this development application also taken to be an application for an environmental authority for an Environmentally Relevant Activity (ERA) under section 115 of the Environmental Protection Act 1994?

Yes – the required attachment (form EM941) for an application for an environmental authority accompanies this development application, and details are provided in the table below

No Note: Application for an environmental authority can be found by searching “EM941” at www.qld.gov.au. An ERA requires an environmental authority to operate. See www.business.qld.gov.au for further information.

Proposed ERA number: Proposed ERA threshold:

Proposed ERA name:

Multiple ERAs are applicable to this development application and the details have been attached in a schedule to this development application.

Hazardous chemical facilities

23.2) Is this development application for a hazardous chemical facility?

Yes – Form 69: Notification of a facility exceeding 10% of schedule 15 threshold is attached to this development application

No Note: See www.justice.qld.gov.au for further information.

Clearing native vegetation

23.3) Does this development application involve clearing native vegetation that requires written confirmation the chief executive of the Vegetation Management Act 1999 is satisfied the clearing is for a relevant purpose under section 22A of the Vegetation Management Act 1999?

Yes – this development application is accompanied by written confirmation from the chief executive of the Vegetation Management Act 1999 (s22A determination)

No Note: See www.qld.gov.au for further information.

Environmental offsets

23.4) Is this development application taken to be a prescribed activity that may have a significant residual impact on a prescribed environmental matter under the Environmental Offsets Act 2014?

Yes – I acknowledge that an environmental offset must be provided for any prescribed activity assessed as having a significant residual impact on a prescribed environmental matter

No Note: The environmental offset section of the Queensland Government’s website can be accessed at www.qld.gov.au for further information on environmental offsets.

Koala conservation

23.5) Does this development application involve a material change of use, reconfiguring a lot or operational work within an assessable development area under Schedule 10, Part 10 of the Planning Regulation 2017?

Yes

No Note: See guidance materials at www.ehp.qld.gov.au for further information.

Water resources

23.6) Does this development application involve taking or interfering with artesian or sub artesian water, taking or interfering with water in a watercourse, lake or spring, taking overland flow water or waterway barrier works?

Yes – the relevant template is completed and attached to this development application

No Note: DA templates are available from www.dilgp.qld.gov.au.

23.7) Does this application involve taking or interfering with artesian or sub artesian water, taking or interfering with water in a watercourse, lake or spring, or taking overland flow water under the Water Act 2000?

Yes – I acknowledge that a relevant water authorisation under the Water Act 2000 may be required prior to

http://www.qld.gov.au/

http://www.business.qld.gov.au/

http://www.justice.qld.gov.au/



http://www.ehp.qld.gov.au/

http://www.dilgp.qld.gov.au/



commencing development

No Note: Contact the Department of Natural Resources and Mines at www.dnrm.qld.gov.au for further information.

Marine activities

23.8) Does this development application involve aquaculture, works within a declared fish habitat area or removal, disturbance or destruction of marine plants?

Yes – an associated resource allocation authority is attached to this development application, if required under the

Fisheries Act 1994

No Note: See guidance materials at www.daf.qld.gov.au for further information.

Quarry materials from a watercourse or lake

23.9) Does this development application involve the removal of quarry materials from a watercourse or lake under the Water Act 2000?

Yes – I acknowledge that a quarry material allocation notice must be obtained prior to commencing development

No

Note: Contact the Department of Natural Resources and Mines at www.dnrm.qld.gov.au for further information.

Quarry materials from land under tidal waters

23.10) Does this development application involve the removal of quarry materials from land under tidal water under the Coastal Protection and Management Act 1995?

Yes – I acknowledge that a quarry material allocation notice must be obtained prior to commencing development

No

Note: Contact the Department of Environment and Heritage Protection at www.ehp.qld.gov.au for further information.

Referable dams

23.11) Does this development application involve a referable dam required to be failure impact assessed under section 343 of the Water Supply (Safety and Reliability) Act 2008 (the Water Supply Act)?

Yes – the ‘Notice Accepting a Failure Impact Assessment’ from the chief executive administering the Water Supply Act is attached to this development application

No Note: See guidance materials at www.dews.qld.gov.au for further information.

Tidal work or development within a coastal management district

23.12) Does this development application involve tidal work or development in a coastal management district?

Yes – the following is included with this development application:

Evidence the proposal meets the code for assessable development that is prescribed tidal work (only required if

application involves prescribed tidal work)

A certificate of title

No Note: See guidance materials at www.ehp.qld.gov.au for further information.

Queensland and local heritage places

23.13) Does this development application propose development on or adjoining a place entered in the Queensland heritage register or on a place entered in a local government’s Local Heritage Register?

Yes – details of the heritage place are provided in the table below

No Note: See guidance materials at www.ehp.qld.gov.au for information requirements regarding development of Queensland heritage places.

Name of the heritage place: Place ID:

Brothels

23.14) Does this development application involve a material change of use for a brothel?

Yes – this development application demonstrates how the proposal meets the code for a development application for a brothel under Schedule 3 of the Prostitution Regulation 2014

No

http://www.dnrm.qld.gov.au/

http://www.daf.qld.gov.au/

http://www.dnrm.qld.gov.au/


http://www.dews.qld.gov.au/





Decision under section 62 of the Transport Infrastructure Act 1994

23.15) Does this development application involve new or changed access to a state-controlled road?

Yes - this application will be taken to be an application for a decision under section 62 of the Transport Infrastructure Act 1994 (subject to the conditions in section 75 of the Transport Infrastructure Act 1994 being satisfied)

No

PART 8 – CHECKLIST AND APPLICANT DECLARATION

24) Development application checklist

I have identified the assessment manager in question 15 and all relevant referral requirement(s) in question 17 Note: See the Planning Regulation 2017 for referral requirements

Yes

If building work is associated with the proposed development, Parts 4 to 6 of Form 2 –Building work details have been completed and attached to this development application

Yes

Not applicable

Supporting information addressing any applicable assessment benchmarks is with development application Note: This is a mandatory requirement and includes any relevant templates under question 23, a planning report and any technical reports required by the relevant categorising instruments (e.g. local government planning schemes, State Planning Policy, State Development Assessment Provisions). For further information, see DA Forms Guide: Planning Report Template.

Yes

Relevant plans of the development are attached to this development application Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms Guide: Relevant plans.

Yes

The portable long service leave levy for QLeave has been paid, or will be paid before a development permit is issued (see 21))

Yes

Not applicable

25) Applicant declaration

By making this development application, I declare that all information in this development application is true and correct

Where an email address is provided in Part 1 of this form, I consent to receive future electronic communications from the assessment manager and any referral agency for the development application where written information is required or permitted pursuant to sections 11 and 12 of the Electronic Transactions Act 2001 Note: It is unlawful to intentionally provide false or misleading information.

Privacy – Personal information collected in this form will be used by the assessment manager and/or chosen assessment manager, any relevant referral agency and/or building certifier (including any professional advisers which may be engaged by those entities) while processing, assessing and deciding the development application. All information relating to this development application may be available for inspection and purchase, and/or published on the assessment manager’s and/or referral agency’s website.

Personal information will not be disclosed for a purpose unrelated to the Planning Act 2016, Planning Regulation 2017 and the DA Rules except where:

such disclosure is in accordance with the provisions about public access to documents contained in the PlanningAct 2016 and the Planning Regulation 2017, and the access rules made under the Planning Act 2016 and Planning

Regulation 2017; or

required by other legislation (including the Right to Information Act 2009); or

otherwise required by law.

This information may be stored in relevant databases. The information collected will be retained as required by the Public Records Act 2002.



PART 9 – FOR OFFICE USE ONLY

Date received: Reference number(s):

Notification of engagement of alternative assessment manager

Prescribed assessment manager

Name of chosen assessment manager

Date chosen assessment manager engaged

Contact number of chosen assessment manager

Relevant licence number(s) of chosen assessment manager

QLeave notification and payment Note: For completion by assessment manager if applicable

Description of the work

QLeave project number

Amount paid ($)

Date paid

Date receipted form sighted by assessment manager

Name of officer who sighted the form

The Planning Act 2016, the Planning Regulation 2017 and the DA Rules are administered by the Department of Infrastructure, Local Government and Planning. This form and all other required development application materials should be sent to the assessment manager.

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This form and any other form relevant to the development application must be used to make a development application relating to strategic port land and Brisbane core port land under the Transport Infrastructure Act 1994, and airport land under the Airport Assets (Restructuring and Disposal) Act 2008. For the purpose of assessing a development application relating to strategic port land and Brisbane core port land, any reference to a planning scheme is taken to mean a land use plan for the strategic port land, Brisbane port land use plan for Brisbane core port land, or a land use plan for airport land.

DA Form 2 – Building work details Approved form (version 1.0 effective 3 July 2017) made under Section 282 of the Planning Act 2016.

This form must be used to make a development application involving building work.

For a development application involving building work only, use this form (DA Form 2) only. The DA Forms Guide provides advice about how to complete this form.

For a development application involving building work associated with any other type of assessable development, use DA Form 1 – Development application details and parts 4 to 6 of this form (DA Form 2).

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.






Postal address (PO Box or street address)

Suburb

State

Postcode

Country

Contact number





PART 2 – LOCATION DETAILS

2) Location of the premises (complete 2.1 and/or 2.2 if applicable)

Note: Provide details below and attach a site plan for any or all premises part of the development application. For further information, see DA Forms Guide: Relevant plans.

2.1) Street address and lot on plan


Street address AND lot on plan for an adjoining or adjacent property of the premises (appropriate for development in water but

adjoining or adjacent to land e.g. jetty, pontoon. All lots must be listed).





2.2) Additional premises

Additional premises are relevant to this development application and the details of these premises have been attached in a schedule to this development application

3) 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 the DA Forms Guide

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

No

PART 3 – FURTHER DETAILS

4) Is the application only for building work assessable against the building assessment provisions?

Yes – proceed to 8)

No

5) Identify the assessment manager(s) who will be assessing this development application

6) Has the local government agreed to apply a superseded planning scheme for this development application?

Yes – a copy of the decision notice is attached to this development application

The local government is taken to have agreed to the superseded planning scheme request – relevant documents attached

No


I agree to receive an information request if determined necessary for this development application

I do not agree to accept an information request for this development application Note: By not agreeing to accept an information request I, the applicant, acknowledge:

that this development application will be assessed and decided based on the information provided when making this development applicationand the assessment manager and any referral agencies relevant to the development application are not obligated under the DA Rules to accept any additional information provided by the applicant for the development application unless agreed to by the relevant parties.



8) Are there any associated development applications or current approvals?

Yes – provide details below or include details in a schedule to this development application

No

List of approval/development application

Reference Date Assessment manager

Approval


Approval




9) Has the portable long service leave levy been paid?

Yes – the yellow local government/private certifier’s copy of the receipted QLeave form is attached to this development application

No – I, the applicant will provide evidence that the portable long service leave levy has been paid before the assessment manager decides the development application. I acknowledge that the assessment manager may give a development approval only if I provide evidence that the portable long service leave levy has been paid

Not applicable

Amount paid Date paid (dd/mm/yy) QLeave levy number (A, B or E)

$

10) Is this development application in response to a show cause notice or required as a result of an enforcement notice?

Yes – show cause or enforcement notice is attached

No

11) Identify any of the following further legislative requirements that apply to any aspect of this development application

The proposed development is on a place entered in the Queensland heritage register or in a local government’s Local Heritage Register. See the guidance provided at www.ehp.qld.gov.au about the requirements in relation to the development of a Queensland heritage place

Name of the heritage place: Place ID:

PART 4 – REFERRAL DETAILS

12) Does this development application include any building work aspects that have any referral requirements?

Yes – the Referral checklist for building work is attached to this development application

No – proceed to Part 5

13) Has any referral agency provided a referral response for this development application?

Yes – referral response(s) received and listed below are attached to this development application

No

Referral requirement Referral agency Date referral response

Identify and describe any changes made to the proposed development application that was the subject of the referral response and the development application the subject of this form, or include details in a schedule to this development application (if applicable)

PART 5 – BUILDING WORK DETAILS

14) Owner’s details

Tick if the applicant is also the owner and proceed to 15). Otherwise, provide the following information.

Name(s) (individual or company full name)

Contact name (applicable for companies)


Suburb




State

Postcode

Contact number




15) Builder’s details

Tick if a builder has not yet been engaged to undertake the work and proceed to 16). Otherwise provide the following information.

Name(s) (individual or company full name)

Contact name (applicable for companies)

QBCC licence or owner – builder number


Suburb

State

Postcode

Contact number




16) Provide details about the proposed building work

a) What type of approval is being sought?

Development permit

Preliminary approval

b) What is the level of assessment?

Code assessment

Impact assessment (requires public notification)

c) Nature of the proposed building work (tick all applicable boxes)

New building or structure

Repairs, alterations or additions

Change of building classification (involving building work) Swimming pool and/or pool fence

Demolition Relocation or removal

d) Provide a description of the work below or in an attached schedule.

e) Proposed construction materials

External walls

Double brick

Brick veneer

Stone/concrete

Steel

Timber

Fibre cement

Curtain glass

Aluminium

Other

Frame Timber

Other

Steel Aluminium

Floor Concrete Timber Other

Roof covering Slate/concrete

Aluminium

Tiles

Steel

Fibre cement

Other



f) Existing building use/classification? (if applicable)

g) New building use/classification? (if applicable)

h) Relevant plansNote: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms Guide: Relevant plans.

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

17) What is the monetary value of the proposed building work? $

18) Has Queensland Home Warranty Scheme Insurance been paid?

Yes – provide details below

No

Amount paid Date paid (dd/mm/yy) Reference number

$


19) Development application checklist

The relevant parts of Form 2 – Building work details have been completed Yes

This development application includes a material change of use, reconfiguring a lot or operational work and is accompanied by a completed Form 1 – Development application details

Yes

Not applicable

Relevant plans of the development are attached to this development application Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms Guide: Relevant plans.

Yes

The portable long service leave levy for QLeave has been paid, or will be paid before a development permit is issued

Yes

Not applicable


By making this development application, I declare that all information in this development application is true and correct

Where an email address is provided in Part 1 of this form, I consent to receive future electronic communications from the assessment manager and any referral agency for the development application where written information is required or permitted pursuant to sections 11 and 12 of the Electronic Transactions Act 2001

Note: It is unlawful to intentionally provide false or misleading information.

Privacy – Personal information collected in this form will be used by the assessment manager and/or chosen assessment manager, any referral agency and/or building certifier (including any professional advisers which may be engaged by those entities) while processing, assessing and deciding the development application.

All information relating to this development application may be available for inspection and purchase, and/or published on the assessment manager’s and/or referral agency’s website.

Personal information will not be disclosed for a purpose unrelated to the Planning Act 2016, Planning Regulation 2017 and the DA Rules except where:

such disclosure is in accordance with the provisions about public access to documents contained in the PlanningAct 2016 and the Planning Regulation 2017, and the access rules made under the Planning Act 2016 and Planning

Regulation 2017; or






PART 7 – FOR OFFICE USE ONLY - FOR COMPLETION BY THE ASSESSMENT MANAGER

Additional building details required for the Australian Bureau of Statistics

Existing building use/classification? (if applicable)

New building use/classification?

Site area (m2) Floor area (m2

)

Additional information required by the local government

Confirm proposed construction materials:

External walls

Double brick

Brick veneer

Stone/concrete

Steel

Timber

Fibre cement

Curtain glass

Aluminium

Other

Frame Timber

Other

Steel Aluminium

Floor Concrete Timber Other

Roof covering Slate/concrete

Aluminium

Tiles

Steel

Fibre cement

Other

Date received: Reference numbers:

For completion by the building certifier

Classification(s) of approved building work QBCC Insurance receipt number

QBCC Certification Licence number

Notification of engagement of alternate chosen assessment manager

Prescribed assessment manager

Name of chosen assessment manager

Date chosen assessment manager engaged

Contact number of chosen assessment manager

Relevant licence number(s) of chosen assessment manager

The Planning Act 2016, the Planning Regulation 2017 and the DA Rules are administered by the Department of Infrastructure, Local Government and Planning. This form and all other required development application materials should be sent to the assessment manager.

The Planning Act 2016 is administered by the Department of Local Government, Infrastructure and Planning, Queensland Government.

Page 1 Planning Act Form 2 – Decision notice (approval)


Decision notice approval Planning Act Form 2 (version 1.0 effective 3 July 2017) made under Section 282 of the Planning Act 2016 for a decision notice (approval) under s63(2) Planning Act 2016

[Application reference number]

[Contact name]

[Contact number]

[Notice date]

[Applicant’s name]

[Applicant’s address]

I acknowledge receipt of the above application on [insert date application received] and confirm the following:

RE: Development application for [Details of proposed development]

[Street address]

[Real property description]

Dear [Applicant name(s)]

I advise that, on [Date of decision]

the above development application was: [Tick applicable box]

approved in full

approved in part for the following [Describe the extent to which the application is approved]

approved in full with conditions* (refer to the conditions contained in Attachment 1)

approved in part for the following [Describe the extent to which the application is approved] with conditions* (refer to the conditions contained in Attachment 1)

*Note: The conditions show which conditions have been imposed by the assessment manager and which conditions

have been imposed by a referral agency.

Planning Act Form 2 – Decision notice (approval)


1. Details of the approval

This application is / is not taken to have been approved (a deemed approval) under section 64(5) of the

Planning Act 2016. [Tick applicable box]

The following approvals are given: [Tick applicable box/es]

Planning Regulation 2017 reference

Development Permit

Preliminary Approval

Development assessable under the planning scheme, a temporary local planning instrument, a master plan or a preliminary approval which includes a variation approval

Carrying out building work (assessable under the Building Act 1975)

Schedule 9, part 1

Development on airport land if the land use plan for the airport land states the development is assessable development

Schedule 10, part 1, division 1

Making a material change of use on airport land that is inconsistent with the approved land use plan for the airport land


Making a material change of use for a brothel Schedule 10, part 2, division 2

Operational work for the clearing of native vegetation Schedule 10, part 3, division 2

Making a material change of use of premises for an environmentally relevant activity


Making a material change of use of premises for aquaculture

Schedule 10, part 6, division 1, subdivision 1

Operational work that is completely or partly within a declared fish habitat area


Operational work that is the removal, destruction or damage of a marine plant


Operational work that is the constructing or raising of a waterway barrier works


Making a material change of use for a hazardous chemical facility


Development on a local heritage place (other than a Queensland heritage place)

- Building work assessable under the Building Act 1975

- Building work assessable under the planning scheme

- Plumbing or drainage work

- Material change of use

- Reconfiguring a lot

- Operational work





Development Permit


Development on a Queensland heritage place

- Building work assessable under the Building Act 1975

- Building work assessable under the planning scheme

- Plumbing or drainage work

- Material change of use

- Reconfiguring a lot

- Operational work


Operational work for reconfiguring a lot, if the reconfiguration is also assessable development


Development in a priority port master planned area that the port overlay for the master planned area states is assessable development


Development on strategic port land if the land use plan for the strategic port land states the development is assessable development


Making a material change of use on strategic port land that is inconsistent with the land use plan


Reconfiguring a lot under the Land Title Act 1994 Schedule 10, part 14, division 1

Making a material change of use of premises for a tourist activity or sport and recreation activity that is assessable development in the SEQ regional landscape and rural production area or the SEQ rural living area


Making a material change of use of premises for a community activity that is assessable development in the SEQ regional landscape and rural production area or the SEQ rural living area


Making a material change of use of premises for indoor recreation that is assessable development in the SEQ regional landscape and rural production area or the SEQ rural living area


Making a material change of use of premises for residential development that is assessable development in the SEQ regional landscape and rural production area or the SEQ rural living area


Making a material change of use of premises for an urban activity that is assessable development in the SEQ regional landscape and rural production area or the SEQ rural living area


Operational work for tidal works or work completely or partly in a coastal management district


Operational work that involves taking, or interfering with, water


Development that is assessable development and involves removing quarry material from a watercourse or lake





Development Permit


Operational work that is assessable development and that is the construction of a dam or relates to a dam.


Operational work that is assessable development for construction of a new category 2 or 3 levee or modification of an existing category 2 or 3 levee


Operational work that that is assessable development and involves high impact earthworks in a wetland protection area


Making a material change of use of premises that is assessable development and is for a wind farm


2. Variation approval details [Strike out this part (Part 2) if it is not applicable to the application]

A preliminary approval which includes a variation approval is given and the assessment manager has

approved a variation to the local planning instrument(s):

[Insert name of local planning instrument]

The variation(s) approved is [Insert details of the variations approved]

3. Conditions [Strike out this part (Part 3) if it is not applicable to the application]

This approval is subject to the conditions in Attachment 1.

4. Further development permits [Strike out this part (Part 4) if it is not applicable to the application]

Please be advised that the following development permits are required to be obtained before the development can be carried out:

5. Properly made submissions [Strike out this part (Part 5) if it is not applicable to the application]

Properly made submissions were /were not made in relation to the application. [Tick applicable box]

There were [Insert the number of properly made submissions] properly made submissions received from the following submitter(s): [For each properly made submission, provide the name and address of the principal submitter. If there were many submissions, the information about the submitters may be provided as an attachment to the decision notice]

Name of principal submitter Residential or business address Electronic address (if provided)

1.

2.

3.



6. Referral agencies for the application [Strike out this part (Part 6) if it is not applicable to the

application]

The referral agencies for this application are:

For an application

involving

Name of referral agency Advice agency or concurrence agency

Address

[List aspect of development

that required referral]

[Insert name of the referral agency]

[Advice agency or concurrence agency, as relevant]

[Insert address for the referral agency]

[List the next aspect of development that required referral. Delete if not applicable or add rows below where there are additional aspects]

7. Environmental authority [Strike out this part (Part 7) if it is not applicable to the application]

[Insert details of any environmental authority given for the application under the Environmental Protection Act 1994]

8. Other requirements under section 44 of the Planning Regulation

8.(a) Building work under section 38 (c) of the Planning Regulation [Strike out this part (Part 8.(a)) if it is not applicable to the application]

The classification OR proposed classification of the building OR parts of the building under the Building code are as follows:

[Insert relevant requirements]

8.(b) Section 38 (e) of the Planning Regulation [Strike out this part (Part 8.(b)) if it is not applicable to the application]

A copy of the written agreement under section 49(4)(b) OR section 66(2)(b) OR section 66(2)(c) is provided. [If relevant, attach the copy of the agreement to the decision notice]

9. Approved plans and specifications [Strike out this part (Part 9) if it is not applicable to the

application]

Copies of the following plans, specification and/or drawings are enclosed. [Add rows below if there are additional aspects]

Drawing/report title Prepared by Date Reference no: Version/issue

Aspect of development: [Insert e.g. material change of use; all]

[Insert details] (as amended in red)

[Insert details] [Insert details] [Insert details] [Insert details]





Aspect of development: [Insert e.g. reconfiguring a lot]





10. Currency period for the approval (s.85)

11. When approval lapses if development started but not completed—preliminaryapproval to which a variation approval applies [Optional]

12. Appeal rights

The rights of an applicant to appeal to a tribunal or the Planning and Environment Court against a decision about a development application are set out in chapter 6, part 1 of the Planning Act 2016. For particular applications, there may also be a right to make an application for a declaration by a tribunal (see chapter 6, part 2 of the Planning Act 2016).

Appeal by an applicant

An applicant for a development application may appeal to the Planning and Environment Court against the following:

the refusal of all or part of the development application

a provision of the development approval

the decision to give a preliminary approval when a development permit was applied for

a deemed refusal of the development application.

An applicant may also have a right to appeal to the Development tribunal. For more information, see schedule 1 of the Planning Act 2016.

Appeal by a submitter

A submitter for a development application may appeal to the Planning and Environment Court against:

any part of the development application for the development approval that required impact assessment

a variation request.

The timeframes for starting an appeal in the Planning and Environment Court are set out in section 229 of the Planning Act 2016.

Attachment 2 is an extract from the Planning Act 2016 that sets down the applicant’s appeal rights and the appeal rights of a submitter.

The Planning Act 2016 is administered by the Department of Local Government, Infrastructure and Planning, Queensland Government.

Page 1 Planning Act Form 3 – Decision notice (refusal)


Decision notice refusal Planning Act Form 3 (version 1.0 effective 3 July 2017) made under Section 282 of the Planning Act 2016 for a decision notice (refusal) under s63(2) Planning Act 2016

[Application reference number]

[Contact name]

[Contact number]

[Notice date]

[Applicant’s name]

[Applicant’s address]

RE: Development application for [Details of proposed development]

[Street address]

[Real property description]

Dear [Applicant name(s)]

I advise that, on [Date of decision]

the above development application was refused.

1. Referral agencies for the application [Strike out this part (Part 1) if it is not applicable to the

application]

The referral agencies for this application are:

For an application involving

Name of referral agency Advice agency or concurrence agency

Address

[List aspect of development requiring referral.]

[Insert name of the referral agency]

[Advice agency or concurrence agency, as relevant]

[Insert address for the referral agency]

[List next aspect of development requiring

referral of the application.

Delete if not applicable]

Planning Act Form 3 – Decision notice (refusal)


2. Details of refusal [Tick the applicable box and, as appropriate, strike out the inapplicable word]

The assessment manager was not directed to refuse the application by a referral agency, or

The assessment manager was directed to refuse the application by [Insert name of referral agency/agencies] in accordance with their referral agency role. The refusal is solely because of the direction of the referral agency/ agencies [Strike out the inapplicable word], or

The assessment manager was directed to refuse the application by [Insert name of referral agency/agencies] in accordance with their referral agency role. The refusal is supported by the assessment manager.

3. Conflict with a relevant instrument and reasons for the decision despite theconflict [Strike out this part (Part 3) if it is not applicable to the application]

The assessment manager does/does not [Strike out the inapplicable word(s)] consider that the assessment manager’s decision conflicts with a relevant instrument [If the decision conflicts with a relevant instrument, complete the following table]

Details of the conflict with the relevant instrument

Reason for the decision, including a statement about the sufficient grounds to justify the decision despite the conflict

4. Reasons for the refusal [Required where the refusal is for a reason other than a referral agency

direction]

The reasons for refusal are:

5. Properly made submissions [Strike out this part (Part 5) if it is not applicable to the application]

There were [Insert number of properly made submissions] / were no [Tick box if applicable] properly made submissions about the application.

Properly made submissions were received from the following principal submitters: [For each properly made submission, provide the name and address of the principal submitter. If there were many submissions, the information about the submitters may be provided as an attachment to the decision notice]

Name of principal submitter Residential/Business Address

Electronic Address (if provided)

1.

2.

3.

Planning Act Form 3 – Decision notice (refusal)


6. Rights of appeal

The rights of an applicant to appeal to a tribunal or the Planning and Environment Court against a decision

about a development application are set out in chapter 6, part 1 of the Planning Act 2016. For particular

applications, there may also be a right to make an application for a declaration by a tribunal (see chapter 6,

part 2 of the Planning Act 2016).

Appeal by an applicant

An applicant for a development application may appeal to the Planning and Environment Court against the following:

the refusal of all or part of the development application

a provision of the development approval

the decision to give a preliminary approval when a development permit was applied for

a deemed refusal of the development application.

The timeframes for starting an appeal in the Planning and Environment Court are set out in section 229 of the

Planning Act 2016.

Attachment 1 is an extract from the Planning Act 2016 that sets down the applicant’s appeal rights.

If you wish to discuss this matter further, please contact me on the above telephone number.

Yours sincerely

[Insert delegate’s name, signature and date]

cc: Each principal submitter and referral agency and any other party required under section 63(1) of the Planning Act [where applicable to the application]

Deemed approval notice Planning Act Form 4 (version 1.0 effective 3 July 2017) made under Section 282 of the Planning Act 2016.

This form must be completed by an applicant giving notice to the assessment manager under section 64(3) of the Planning Act 2016 that the application should be approved by the assessment manager.

Note: A deemed approval notice can only be provided to the assessment manager for certain types of applications and must be provided before the application is decided. Please see the notes at the end of this form for further information.

A copy of this notice must also be provided to each referral agency, the local government (if the local government is not the assessment manager) and the prescribed assessment manager if the assessment manager is a chosen assessment manager.





Suburb

State

Postcode

Country

Contact number





2) Details of the development applied for

Provide details of the development (e.g. reconfiguring a lot, material change of use for a 6 unit multiple dwelling etc.)

3) Type of approval applied for

Development permit Preliminary approval Both a development permit and a preliminary approval

4) Premises to which the development application relates

Identify the premises as provided for below. Ensure all premises are included by adding additional rows as necessary


Street address AND lot on plan for an adjoining or adjacent property of the premises (appropriate for development in water

but adjoining or adjacent to land e.g. a jetty, pontoon. All lots must be listed).

a)



b) Unit No. Street No. Street Name and Type Suburb

Planning Act Form 4 – Deemed approval notice



Coordinates of premises by longitude and latitude

Longitude(s) Latitude(s) Datum Local Government Area(s) (if applicable)

WGS84

GDA94

Other:

Coordinates of premises by easting and northing

Easting(s) Northing(s) Zone Ref. Datum Local Government Area(s) (if applicable)

54

55

56

WGS84

GDA94

Other:

5) Date application was made

6) Assessment manager’s reference number (if known)

7) Date the decision making period ended

This is the date the assessment manager was required to make its decision

Planning Act Form 4 – Deemed approval notice


Notes for completing this form:

A deemed approval notice can only be provided to the assessment manager for a development applicationrequiring code assessment and cannot be provided for an application:

o that includes a variation request

o in relation to which a referral agency has directed the assessment manager to give a development approval foronly a part of the application or to refuse the application

o that includes development for which the building assessment provisions are an assessment benchmark

o that is subject to a direction from the Minister under section 95(1)(b) of the Planning Act 2016 and the statedperiod has not ended.

A deemed approval notice can only be given if the assessment manager does not decide the application withinthe period, or extended period, provided for in the Development Assessment Rules. The deemed approvalnotice must be provided to the assessment manager before the application is decided.

Privacy - please refer to your assessment manager for further details on the use of information recorded in this form.

OFFICE USE ONLY


Change application form Planning Act Form 5 (version 1.0 effective 3 July 2017) made under Section 282 of the Planning Act 2016.

This form is to be used for a change an application made under section 78 of the Planning Act 2016. It is important when making a change application to be aware of whether the application is for a minor change that will be assessed under section 81 of the Planning Act 2016 or for an ‘other’ change that will be assessed under section 82 of the Planning Act 2016.

An applicant must complete all parts of this form, and provide any supporting information that the form identifies as being required to accompany the change application, unless stated otherwise. Additional pages may be attached if there is insufficient space on the form to complete any part.







Suburb

State

Postcode

Country




2) Owner’s consent - Is written consent of the owner required for this change application?

Note: section 79(1)(b)(iii) of the Planning Act 2016 states the requirements in relation to owner’s consent.

Yes – the written consent of the owner(s) is attached to this change application

No – proceed to 3) in Part 2

PART 2 – RESPONSIBLE ENTITY DETAILS

3) Identify the responsible entity that will be assessing this change application

Note: see section 78(3) of the Planning Act 2016

PART 3 – CHANGE DETAILS

Approval type Reference number Date issued Assessment manager/approval entity

Development permit


Development permit


4) Provide details of the existing development approval subject to this change application

Planning Act Form 5 - Change application form


5) Type of change proposed

5.1) Provide a brief description of the changes proposed to the development approval (e.g. changing a development approval for a

5 unit apartment building to provide for a 6 unit apartment building):

5.2) What type of change does this application propose?

Minor change application – proceed to Part 4

Other change application – proceed to Part 5

PART 4 – MINOR CHANGE APPLICATION REQUIREMENTS

6) Are there any affected entities for this change application

No – proceed to Part 6

Yes – list all affected entities below and proceed to Part 6

Note: section 80(1) of the Planning Act 2016 states that the person making the change application must give notice of the proposal and the details of the change to each affected entity as identified in section 80(2) of the Planning Act 2016.

Affected entity Pre-request response provided? (where a pre-request response notice for the application has been given, a copy of the notice must accompany this change application)

Date notice given (where no pre-request response provided)

No

Yes – pre-request response is attached to this change application

No


No


PART 5 – OTHER CHANGE APPLICATION REQUIREMENTS Note: to complete this part it will be necessary for you to complete parts of DA Form 1 and in some instances parts of DA Form 2, as mentioned below. These forms are available at www.dilgp.qld.gov.au.

7) Location details - Are there any additional premises included in this change application that were not part of the originaldevelopment approval?

No

Yes – complete Part 2 (Location details) of DA Form 1 as it relates to the additional premises is completed and provided with this application.

8) Development details

8.1) Are there any new or changed development aspects included in this change application that are not part of the original development approval?

No – proceed to 9)

Yes – the completed Sections 1 and 2 of Part 3 (Development details) of DA Form 1 as these sections relate to the new or changed aspects of development are provided with this application.

8.2) Does the change application involve building work?

No

Yes – the completed Part 5 (Building work details) of DA Form 2 as it relates to the change application is provided with this application.

www.dilgp.qld.gov.au



9) Referral details - Do any aspects of the change application require referral for any referral requirements?Note: The application must be referred to each referral agency triggered by the change application as if the change application was the original development application including the proposed change.

No

Yes – the completed Sections 1 and 2 of Part 5 (Referral details) of DA Form 1 as it relates to the change application is provided with this application. Where referral is required for matters relating to building work the referral checklist for building work is also completed.


I agree to receive an information request if determined necessary for this change application

I do not agree to accept an information request for this change application

Note: By not agreeing to accept an information request I, the applicant, acknowledge:

that this change application will be assessed and decided based on the information provided when making this change applicationand the assessment manager and any referral agencies relevant to the change application are not obligated under the DA Rules toaccept any additional information provided by the applicant for the change application unless agreed to by the relevant parties



11) Further details

Part 7 of DA Form 1 is completed as if the change application was a development application and is provided with this application.


12) change application checklist

I have identified the:

responsible entity in 3); and

for a minor change, any affected entities; and

for an ‘other’ change all relevant referral requirement(s) in 9)

Note: See the Planning Regulation 2017 for referral requirements

Yes

For an ‘other’ change application, the relevant sections of DA Form 1 – Development details have been completed and is attached to this application

Yes

Not applicable

For an ‘other’ change application, where building work is associated with the change application, the relevant sections of Form 2 – Building work details have been completed and is attached to this application

Yes

Not applicable

Supporting information addressing any applicable assessment benchmarks is attached to this application

Note: This includes any templates provided under 23.6) of DA Form 1 that are relevant as a result of the change application, a planning report and any technical reports required by the relevant categorising instrument(s) (e.g. the local government planning scheme, State Planning Policy, State Development Assessment Provisions). For further information, see DA Forms Guide: Planning report template.

Yes

Relevant plans of the development are attached to this development application

Note: Relevant plans are required to be submitted for all relevant aspects of this change application. For further information, see DA Forms Guide: Relevant plans.

Yes


By making this change application, I declare that all information in this change application is true and correct.

Where an email address is provided in Part 1 of this form, I consent to receive future electronic communications from the responsible entity and any relevant affected entity or referral agency for the change application where written information is required or permitted pursuant to sections 11 and 12 of the Electronic Transactions Act 2001.

Note: It is unlawful to intentionally provide false or misleading information.



Privacy – Personal information collected in this form will be used by the responsible entity and/or chosen assessment manager, any relevant affected entity or referral agency and/or building certifier (including any professional advisers which may be engaged by those entities) while processing, assessing and deciding the change application.

All information relating to this change application may be available for inspection and purchase, and/or published on the assessment manager’s and/or referral agency’s website.

Personal information will not be disclosed for a purpose unrelated to the Planning Act 2016, Planning Regulation 2017 and

the DA Rules except where:

such disclosure is in accordance with the provisions about public access to documents contained in the Planning Act2016 and the Planning Regulation 2017, and the access rules made under the Planning Act 2016 and Planning

Regulation 2017; or




PART 7 – FOR OFFICE USE ONLY


QLeave notification and payment Note: For completion by assessment manager if applicable

Description of the work

QLeave project number

Amount paid ($)

Date paid

Date receipted form sighted by assessment manager

Name of officer who sighted the form

The Planning Act 2016, the Planning Regulation 2017 and the DA Rules are administered by the Department of Infrastructure, Local Government and Planning. This form and all other required change application materials should be sent to the responsible entity.

Planning Act Form MGR5.1 – LGIP review checklist


LGIP review checklist Approved form MGR5.1 under the Planning Act 2016

Review principles:

A reference in the checklist to the LGIP is taken to include a relevant reference to the Planning Act 2016 and chapter 5 of the Minister’s Guidelines and Rules.

Terms in this checklist that are defined in the Planning Act 2016 or the Minister’s Guidelines and Rules. The checklist must not be taken to cover all requirements of the Planning Act 2016 and the Minister’s Guidelines and Rules. Local governments must still have regard to the requirements as set out in the Planning Act 2016 and the Minister’s Guidelines and Rules when preparing or amending an LGIP.

Local government infrastructure plan (LGIP) checklist To be completed by local government To be completed by appointed reviewer

LGIP outcome

LGIP component

Number Requirement Requirement met (yes/no)

Local government comments

Compliant (yes/no)

Justification Corrective action description

Recommendation

The LGIP is consistent with the legislation for LGIPs and the Minister’s Guidelines and Rules

All

1. The LGIP sections are ordered in accordance with the LGIP template.

2. The LGIP sections are correctly located in the planning scheme.

3. The content and text complies with the mandatory components of the LGIP template.

4. Text references to numbered paragraphs, tables and maps are correct.

Definitions 5. Additional definitions do not conflict with statutory requirements.

Preliminary section

6. The drafting of the Preliminary section is consistent with the LGIP template.

7. All five trunk networks are included in the LGIP. (If not, which of the networks are excluded and why have they been excluded?)

Planning assumptions - structure

8. The drafting of the Planning assumptions section is consistent with the LGIP template.

9. All the projection areas listed in the tables of projections are shown on the relevant maps and vice versa.

10. All the service catchments listed in the tables of projected infrastructure demand

are identified on the relevant plans for trunk infrastructure (PFTI) maps and vice versa.

Planning assumptions - methodology

11. The population and dwelling projections are based on those prepared by the Queensland Government Statistician (as available at the time of preparation) and refined to reflect development trends in the local government area.

12. The employment and non-residential development projections align with the available economic development studies, other reports about employment or historical rates for the area.

13. The developable area excludes all areas affected by absolute constraints such as steep slopes, conservation and flooding.

14. The planned densities reflect realistic levels and types of development having regard to the planning scheme provisions and current development trends.



15. The planned densities account for land required for local roads and other infrastructure.

16. The population and employment projection tables identify “ultimate development” in accordance with the defined term.

17. Based on the information in the projection tables and other available material, it is possible to verify the remaining capacity to accommodate growth, for each projection area.

18. The determination of planning assumptions about the type, scale, timing and location of development, reflect an efficient, sequential pattern of development.

19. The relevant state agency for transport matters and the distributor-retailer responsible for providing water and wastewater services for the area (if applicable), has been consulted in the preparation of the LGIP (What was the outcome of the consultation?)

Planning assumptions - demand

20. The infrastructure demand projections are based on the projections of population and employment growth.

21. The infrastructure units of demand align with those identified in the Minister’s Guidelines and Rules, or where alternative demand units are used, their numerical relationship to the standard units of demand is identified and explained.

22. The demand generation rates align with accepted rates and/or historical data.

23. The service catchments used for infrastructure demand projections are identified on relevant PFTI maps and demand tables.

24. The service catchments for each network cover, at a minimum, the urban areas, and enable urban development costs to be compared.

25. The asset management plan (AMP) and Long Term Financial Forecast (LTFF) align with the LGIP projections of growth and demand. (If not, what process is underway to achieve this?)

Priority infrastructure area (PIA)

26. The drafting of the PIA section is consistent with the LGIP template.

27. Text references to PIA map(s) are correct. 28. The PIA boundary shown on the PIA map is

legible at a lot level and the planning scheme zoning is also shown on the map.

29. The PIA includes all areas of existing urban development serviced by all relevant trunk infrastructure networks at the time the LGIP was prepared.

30. The PIA accommodates growth for at least 10 years but no more than 15 years.



31. The PIA achieves an efficient, sequential pattern of development.

32. If there is an area outside the PIA that the planning assumptions show is needed for urban growth in the next 10 to 15 years, why has the area been excluded from the PIA?

Desired standards of service (DSS)

33. The drafting of the DSS section is consistent with the LGIP template.

34. The DSS section states the key planning and design standards for each network.

35. The DSS reflects the key, high level industry standards, regulations and codes, and planning scheme policies about infrastructure.

36. There is alignment between the relevant levels of service stated in the local government’s AMP and the LGIP. (If not, what process is underway to achieve this?)

Plans for trunk infrastructure (PFTI) – structure and text

37. The drafting of the PFTI section is consistent with the LGIP template.

38. PFTI maps are identified for all networks listed in the Preliminary section.

39. PFTI schedule of works summary tables for future infrastructure are included for all networks listed in the Preliminary section.

PFTI – Maps [Add rows to the checklist to address these items for each of the networks]

40. The maps clearly differentiate between existing and future trunk infrastructure networks.

41. The service catchments referenced in the schedule of works (SOW) model and infrastructure demand summary tables are shown clearly on the maps.

42. Future trunk infrastructure components are identified (at summary project level) clearly on the maps including a legible map reference.

43. The infrastructure map reference is shown in the SOW model and summary schedule of works table in the LGIP.

Schedules of works [Add rows to the checklist to address these items for each of the networks]

44. The schedule of works tables in the LGIP comply with the LGIP template.

45. The identified trunk infrastructure is consistent with the Planning Act 2016 and the Minister’s Guidelines and Rules.

46. The existing and future trunk infrastructure identified in the LGIP is adequate to service at least the area of the PIA.

47. Future urban areas outside the PIA and the demand that will be generated at ultimate development for the relevant network catchments have been considered when determining the trunk infrastructure included in the SOW model.

48. There is alignment of the scope, estimated cost and planned timing of proposed trunk capital works contained in the SOW model



and the relevant inputs of the AMP and LTFF. (If not, what process is underway to achieve this?)

49. The cost of trunk infrastructure identified in the SOW model and schedule of work tables is consistent with legislative requirements.

SOW model 50. The submitted SOW model is consistent with the SOW model included in the Minister’s Guidelines and Rules.

51. The SOW model has been prepared and populated consistent with the Minister’s Guidelines and Rules.

52. Project owner’s cost and contingency values in the SOW model do not exceed the ranges outlined in the Minister’s Guidelines and Rules.

53. Infrastructure items included in the SOW model, SOW tables and the PFTI maps are consistent.

Extrinsic material

54. All relevant material including background studies, reports and supporting information that informed the preparation of the proposed LGIP is available and identified in the list of extrinsic material.

55. The extrinsic material explains the methodology and inter-relationships between the components and assumptions of the LGIP.

The Planning Act 2016 is administered by the Department of Local Government, Infrastructure and Planning, Queensland Government

Page 1 Planning Act Form MGR5.2 – Appointed reviewer template statement


Appointed reviewer statement template Approved form MGR5.2 under the Planning Act 2016

<First / Second> Compliance check of <insert Local government’s name> local government infrastructure plan

Prepared by: <insert Appointed reviewer’s name>

Version Date Reviewer name and signature

Final

Planning Act Form MGR5.2 – Appointed reviewer template statement


Introduction

<Insert Reviewer’s name> has been engaged by <insert Local government’s name> to undertake a <first / second> compliance check of its proposed Local Government Infrastructure Plan (LGIP) or amendment to a current LGIP. < Insert Reviewers name> is required to: (1) evaluate whether a proposed LGIP or amendment complies with the requirements outlined

under the Planning Act 2016 and the Minister’s Guidelines and Rules, including:

(a) the SOW model requirements in Schedule 7 of the Guideline and Rules;

(b) the LGIP template;

(c) the approved form MGR5.1 – LGIP Review Checklist; and

(2) comply with the fundamental ethical principles of integrity, objectivity, professional competence, due care and professional behaviour when reviewing the LGIP; and

(3) provide a written statement and the completed checklist to the local government detailing the findings of the compliance check.

Scope exclusions

The following items are outside the scope of this review:

A verification of the accuracy of individual inputs used in the preparation of an LGIP.

A review of the local government’s Long Term Financial Forecast (LTFF) or asset management plan (AMP) other than to determine the extent of their alignment with the LGIP.



Compliance check process

The process used for the compliance check is as follows:

Stage Description

Engaged

• Documents and other information requested from < name of local government> on <date> ,

• Documents and other information provided by <name of local government> on <date>

Review • Review commenced on <date> • Additional information requested on <date> and received on <date> • Meeting held with local government on <date>

Final report • Final report issued on <date>

The following local government personnel were involved in the compliance check:

Name Title Date of discussion (s)

Scope of discussion

e.g. Director, Strategic Planning

<date(s)> Insert a dot point list of issues discussed; e.g. • LGIP growth projection • Financial inputs



Compliance check findings

Insert any comments here that may be necessary to support the completed LGIP compliance check.

Insert comments about the outcomes of any local government consultation with:

(a) the relevant state agency responsible for transport matters, and

(b) a distributor-retailer responsible for providing water and wastewater services for the area (if applicable).



Conclusions

Use this section to discuss and substantiate the overall outcomes of the compliance check and to provide a basis for the recommendation to follow.

Recommendations

<insert name of reviewer> recommends to the <insert name of local government> that the LGIP should <select one of the below recommendations>:

proceed unchanged; or

proceed subject to conditions described below; or

not proceed.

Recommended conditions to be imposed

<list recommended conditions that may be imposed to address any identified issues (if relevant)>

Approved forms under the Planning Act 2016 · Summary of approved forms . Form name Requirement...

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