3rd Year Assessment - DA

Page 1

Development Application Form About this form:

Use this form to apply for a Development Application.

How to complete:

1. Ensure that all fields have been filled out correctly. 2. Please print clearly 3. Once completed, please refer to the lodgement details section for further information.

PART A – APPLICATION AND SITE DETAILS NOTE: Part A of this application form must be provided separately in the electronic copy of documentation. Part B of this form, with your completed details, may be publicly available on Council’s website.

Applicant Details: Please print clearly and give all contact details. If the applicant is a company, proof the company is a legal entity must be given, either by company seal or company letterhead.

Salutation: (please tick)

 Mr

 Ms

 Miss

 Other (please specify)

Company Name (if applicable) First name:

Bernadette Balatbat

Email:

bbal8495@uni.sydney.edu.au

Surname:

Balatbat

Street address:

Postcode:

2141

Suburb: Postal address: (if different to street address) Suburb:

Postcode:

Phone number:

Mobile: 0431308726

Other:

Site Details: Please list all properties subject to this application Customer Reference Number: 1 Tawa Street Street address: Suburb:

Ashfield

Legal description:

Lot: 3

Current rating category of land: Proposed rating category of land: Has the current Application had a Pre-DA?

Inner West Council Development Application Form

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Postcode: DP/SP: 16828

Section:

 Business  Business x  Yes

2131

x Residential  x Residential 

 Mixed development  Mixed development

No If YES, please provide application number:

council@innerwest.nsw.gov.au PO Box 14, Petersham, NSW 2049

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Updated August 2019 Page 1 of 10


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