Approval Package Ref No. SDA 0714 019605 27 October 2014, 10.00 am Generated IDAS Form 4 for application 16605
IDAS form 4—Local heritage place (Sustainable Planning Act 2009 version 3.0 effective 1 July 2013)
This form must be used for development applications for development on a local heritage place that is assessable development. You MUST complete ALL questions that are stated to be a mandatory requirement unless otherwise identified on this form. For all development applications, you must: complete IDAS form 1—Application details # complete any other forms relevant to your application # provide any mandatory supporting information identified on the forms as being required to # accompany your application. Attach extra pages if there is insufficient space on this form. All terms used on this form have the meaning given in the Sustainable Planning Act 2009 or the Sustainable Planning Regulation 2009. This form can also be completed online using MyDAS at www.dsdip.qld.gov.au/MyDAS Mandatory requirements 1. What is the name of the local heritage place and the corresponding Local Heritage Register number? (if applicable) Name of the local heritage place local heritage
Local Heritage Register number 1234
2. Provide a brief description of any proposed works and an estimate of the cost of any building or operational work (use a separate row for each type of development) Description of the proposed development local heritage
Estimated value of the works ($) 123
Mandatory Supporting Information 3. Confirm that the following mandatory supporting information accompanies this application Mandatory supporting information A statement of the impact of the proposed development on the cultural heritage significance of the local heritage place. This statement must describe the relative values of the physical attributes of the place which contribute to the cultural heritage significance (as described in the Local Heritage Register) and how these are conserved or impacted upon as part of the development A written statement of works
Confirmation of lodgement Confirmed
Method of lodgement
Confirmed Site plans showing the location of the proposed works
Confirmed
Plans, sections and elevations to scale of the proposed work
Confirmed
Non-mandatory supporting information 4. Confirm the following non-mandatory supporting information accompanies this application Non-mandatory supporting information
Confirmation of lodgement
Photos demonstrating the existing condition of the local heritage place
Method of lodgement
Confirmed Not Applicable
A conservation management plan for the local heritage place
Confirmed Not Applicable
Specifications of proposed work, materials and work methods
Confirmed Not Applicable
Engineering and other sub-consultant drawings (e.g. electrical, acoustic)
Confirmed Not Applicable
Other relevant information—provide details below
Confirmed Not Applicable
Privacy—Please refer to your assessment manager, referral agency and/or building certifier for further details on the use of information recorded in this form. OFFICE USE ONLY Date received
Reference numbers
The Sustainable Planning Act 2009 is administered by the Department of State Development, Infrastructure and Planning. This form and all other required application materials should be sent to your assessment manager and any referral agency. Department of State Development, Infrastructure and Planning PO Box 15009 City East Qld 4002 Tel 13 QGOV (13 74 68) [email protected] www.dsdip.qld.gov.au IDAS form 4—Local heritage place Version 3.0 1July 2013
This form must be used for development applications for development on a local heritage place that is assessable development. You MUST complete ALL questions that are stated to be a mandatory requirement unless otherwise identified on this form. For all development applications, you must: complete IDAS form 1—Application details # complete any other forms relevant to your application # provide any mandatory supporting information identified on the forms as being required to # accompany your application. Attach extra pages if there is insufficient space on this form. All terms used on this form have the meaning given in the Sustainable Planning Act 2009 or the Sustainable Planning Regulation 2009. This form can also be completed online using MyDAS at www.dsdip.qld.gov.au/MyDAS Mandatory requirements 1. What is the name of the local heritage place and the corresponding Local Heritage Register number? (if applicable) Name of the local heritage place local heritage
Local Heritage Register number 1234
2. Provide a brief description of any proposed works and an estimate of the cost of any building or operational work (use a separate row for each type of development) Description of the proposed development local heritage
Estimated value of the works ($) 123
Mandatory Supporting Information 3. Confirm that the following mandatory supporting information accompanies this application Mandatory supporting information A statement of the impact of the proposed development on the cultural heritage significance of the local heritage place. This statement must describe the relative values of the physical attributes of the place which contribute to the cultural heritage significance (as described in the Local Heritage Register) and how these are conserved or impacted upon as part of the development A written statement of works
Confirmation of lodgement Confirmed
Method of lodgement
Confirmed Site plans showing the location of the proposed works
Confirmed
Plans, sections and elevations to scale of the proposed work
Confirmed
Non-mandatory supporting information 4. Confirm the following non-mandatory supporting information accompanies this application Non-mandatory supporting information
Confirmation of lodgement
Photos demonstrating the existing condition of the local heritage place
Method of lodgement
Confirmed Not Applicable
A conservation management plan for the local heritage place
Confirmed Not Applicable
Specifications of proposed work, materials and work methods
Confirmed Not Applicable
Engineering and other sub-consultant drawings (e.g. electrical, acoustic)
Confirmed Not Applicable
Other relevant information—provide details below
Confirmed Not Applicable
Privacy—Please refer to your assessment manager, referral agency and/or building certifier for further details on the use of information recorded in this form. OFFICE USE ONLY Date received
Reference numbers
The Sustainable Planning Act 2009 is administered by the Department of State Development, Infrastructure and Planning. This form and all other required application materials should be sent to your assessment manager and any referral agency. Department of State Development, Infrastructure and Planning PO Box 15009 City East Qld 4002 Tel 13 QGOV (13 74 68) [email protected] www.dsdip.qld.gov.au IDAS form 4—Local heritage place Version 3.0 1July 2013
