Developer Contributions Section Planning Environment & Transport Directorate Phone: 5582 8052 Facsimile: 5582 8241 Email: dcg@goldcoast.qld.gov.au PO Box 5042 GOLD COAST MC QLD 9729 Infrastructure Charges Reconfiguration of Lot (ROL) Gold Coast City Council is collecting your personal information in order for us to calculate infrastructure charges in accordance with the Sustainable Planning Act 2009 and other legislation. This information will only be used by authorised Council officers for the purpose of calculating infrastructure charges and ensuring our records are accurate. Some of your personal information may also be made available to Allconnex Water and Councils Planning & Development Online web site for public viewing in accordance with the Sustainable Planning Act 2009. Your information will not be given to any other person or agency unless you have given us permission or we are required by law. Section A – details of proposed lots(s) to be developed Purpose Number of proposed lots Size Residential >0.1 Ha Residential <0.1Ha Park living Management Non-residential Total number of proposed lots Section B – not-for-profit declaration Are you a Not-For-Profit Community Group? Note: This information is not applicable in regards to estimate requests. Yes No How to fill out this form Use of this form Section A details of proposed lot(s) to be developed Use this form to provide details of a development application involving a Reconfiguration of Lot (ROL). The following Lot types describe the purposes available for a development: Residential Lot greater than 0.1 hectares in size Residential Lot less than or equal to 0.1 hectares in size Park Living Lot Management Lot Non-Residential Lot You will need to enter the number of Proposed Lots of each type in your development. Lots that will be designated ‘Public Open Space’ should not be included in the table. Proposed Lots with a site area less than 4000 m2 cannot have a purpose of ‘Park Living’ and must be included under one of the other categories. At the bottom of the table, insert the total number of all the Proposed Lots in your development. Section B not-for-profit declaration If you are a not-for-profit community group, you may be entitled to a rebate on the charges you must pay, so tick the check box and fill out the Infrastructure Charges Not-For-Profit Rebate Request form contained in your application kit. Assessment of “Not-For-Profit” Applications will not be conducted by Council when assessing Infrastructure Charge Estimates. Office use only Application received by Application number Receipt number Fees paid $ Date Doc # 19782690\12 Sundry debtor number Sundry debtor name Last updated: 6/6/2011 Working for our future - to Working for our future - today