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for single dwelling houses, granny flats and associated ancillary structures only property details Please provide the following details Lot N o/s. Section N o. DP N o. A statement of environmental effects is required on all development applications. It examines the impact of the proposal and how these impacts can be minimised Street N o. Street Name Township Postcode proposal details Brief outline of the proposed work Maps and details of zonings, protected areas, heritage items and bushfire areas can be found on Council s website www.bmcc.nsw.gov.au planning details What is the zoning of the land? LEP. Is the property affected by a protected area or environmental constraint area? If yes, please attach details of the area, its location and proximity to the development. If the development is located within these areas a detailed environmental assessment will also be required. Refer to the plan requirements in C1.1 Biodiversity. Is the proposal permissible within the zoning? Refer to the Local Environmental Plan(LEP). Are there any restrictions on the Certificate of Title? If yes, please attach a copy of the convenant or restriction. What is the site coverage? For definitions on site cover refer to the development standards in the LEP or Better Living DCP. Please select the appropriate LEP To determine the level of construction refer to the NSW Rural Fire Service Guidelines for Single Dwelling Development Applications www.rfs.nsw.gov.au SOEE-3 LEP 2005 Existing Proposed Building site coverage % or m² LEP 1991 Existing Proposed tional development area m² Principal development area m² (if applicable) Building site coverage % or m² Is the development located on Bushfire Prone Land? If yes, state the level of threat. Refer to Rural Fire Service Single Dwelling Development Applications for details. Indicate the balance attack level (BAL) BAL-12.5 BAL-19 BAL-29 BAL-40 BAL-FZ Attach a bushfire threat assessment; detail the level of construction on the plans. Refer to C4.1 Bushfire of the Better Living Development Control Plan (DCP).

You must tick the boxes to show that you have considered these issues Please refer to the appropriate section in the Better Living Development Control Plan (DCP) Attach details where required site details checklist Does the site contain undisturbed areas of native vegetation or is it adjacent to areas of bushland? If yes, a detailed may be required depending on vegetation type and likelihood of habitats. Refer to plan requirements in C1.1 Biodiversity. Is the area to be cleared located within 40 metres of a watercourse (permanent or intermittent)? If yes, refer to general information in C1.1 Biodiversity. Does the site contain any rocky outcrops, rock ledges or other significant natural features? If yes, refer to general information in C1.1 Biodiversity. Are there any noxious weeds on the site? If yes, a weed management strategy may be required refer to plan requirements in C1.2 Weeds. Is the site classified as potentially contaminated or is it currently or has been previously used for a purpose that may have resulted in it being contaminated? Refer to C4.3 Land Contamination to determine. Does the proposal involve any demolition works? If yes, complete the section on waste management on this form. Refer to general information in C1.4 Site Management. Is there any asbestos on the site / building? If yes, refer to general information in C1.4 Site Management. Is there disturbance to any area containing lead paint? If yes, refer to general information in C1.4 Site Management. Is the area of land to be disturbed greater than 50m²? If yes, an erosion and sediment control plan is required. Refer to plan requirements in C1.4 Site Management. Maps and details of protected areas, water supply catchment areas and heritage items can be found on Council s website www.bmcc.nsw.gov.au Is the site listed on a heritage register, adjoins a heritage item or located within a heritage conservation area? If yes, a heritage assessment may be required. Refer to documentation requirements in C3 Heritage. Is the site located within a Protected Area - Period Housing Area? If yes, a detailed character assessment is required. Refer to documentation requirements in C2.1 Streetscape and Character. Is the site accessed via an unformed road? If yes, you need to apply for a Roads Act Approval on the Land Use Application form. Is the development within 60 metres of a railway corridor? If yes, refer to plan requirements in C5.4 Amenity. Is the development located on a main transport corridor? (eg., GWH, Hawkesbury Road, Bells Line of Road). If yes, a noise and vibration report may be required. Refer to documentation requirements C5.4 Amenity. Is the site classified as being subject to innundation? This information is shown on a 149(2) Planning Certificate. Is the property connected to reticulated sewer? If you are uncertain please check with Sydney Water. Is the property located within a Water Supply Catchment Area? This can be obtained from Council s maps.

Development standards for single dwellings are referenced in the Better Living DCP in Parts D1 and E1 varying a standard Is the design contrary to a development standard? If yes, please indicate whether it is a: Local Environmental Plan (LEP) development standard? and/or Development Control Plan (DCP) development standard? Please attached detailed documentation indicating the development standard to be varied and reasons in support of the variation. Reference must be made to the performance criteria or objectives of the LEP or DCP. effects and mitigation measures building biodiversity Provide an outline of measures taken to reduce the impact on the environment and to build biodiversity. This could include a site responsive design; limited clearing; use of recycled materials/plants; retention of natural features and native habitats; regeneration of native areas, etc. Refer to C1.1 Biodiversity. Mountain Landscapes, an interactive web site, provides a list of plants that are local to each village www.bmcc.nsw.gov.au stormwater measures For new dwellings BASIX will also cover stormwater requirements The development proposes the following retention and / or detention stormwater management measures. Indicate whether rainwater on the site flows naturally to the: front rear side Look at detention and retention measures to contain potential upstream and downstream effects. Detention limits the quantity and velocity of stormwarter discharge. Retention is the methods used to store stormwater on the site for later reuse. For example, collection and reuse of rainwater, use of infiltration trenches, discharge to pipes etc. See C1.3 Stormwater and the development standards for single dwellings in Parts D1 and E1.

site management Should the proposal involve the removal of any asbestos cement, you will need to refer to Working With Asbestos Guide on www.workcover..nsw.gov.au What are the proposed arrangements for the management and minimisation of waste during construction. If demolition is proposed indicate the extent and order of demolition, the type of materials and disposal techniques including asbestos removal and disposal. See C1.4 Site management. streetscape and character statement Provide a statement on the character of the streetscape, the locality and how the proposal addresses these elements. Compare the predominent features such as height; design style and gardens elements. See C2.1 Streetscape and Character. Attach a schedule of external materials and colours. statement on crime minimisation strategies State measures that have been incorporated into the proposal that consider crime minimisation strategies. This might include natural surveillance areas, clearly defined access points, lighting and security. See C4.2 Crime Minimisation.

vehicular access details (if applicable) effects and mitigation measures Provide a statement on vehicular access, driveway design and location. Include measures taken to mitigate the impact. Consider the type and load of vehicular and pedestrian traffic within the street. Include driveway design, grade, surface material and its position in relation to natural features (identify the driveway on the site plan). On difficult sites vehicular access designs will be required. amenity impacts Will the proposal impact on adjoining residents: Overshadowing? Shadow diagrams may be required. Privacy? Views? ise? eg., external airconditioners, pool pumps etc. Does the proposal involve a fuel heater? If yes, include on the location on the floor plan and attach the heater specifications. Outline the measures taken to minimise the impact. See C5.4 Amenity

wastewater Waste minimisation management (if applicable) Maps are available showing catchment areas effects and mitigation measures Complete this section if the property is NOT connected to sewer. Disposal of wastewater is off-site on-site Where the proposal adds bedrooms (studios and studies are counted as bedrooms), then you will need to indicate the impact on the existing system by the intensified use. Provide details on the type of system, its size and how the additional loads can be accommodated. Have you considered making your home adaptable? For further information read C5.6 Adaptability in the Better Living DCP. Crime minimisation list of plans & documents Type of plan / document title Prepared by Dated List the plans and statements that have been provided to support the development application Any information supplied electronically and in paper form must be identical. The notification plan Any other large details scale required and site plan. to support application must also mirror any elevation, sections Please include an A4 / A3 copy showing the site plan and elevation plan.