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The person certifying that the plan is a true and correct record of what has been constructed within the specified tolerances required by Council. Application details Our reference file number PNxxxxx/03xDAx OPW application number OPW property details Property lot and plan number Estate name and stage Total number of lots Number of residential lots Number of park lots Number of commercial lots Number of management lots Property street address Consulting engineers details Company name Postal address Email address Phone number Mobile number Job reference number Supporting documentation Sewer Water Stormwater Spot levels Open space Other information required as a condition of the development permit Other supporting information There is no fee associated with this form. Office use only Date received AMS application number iSpot 22743319 v12 Received by ASC Last Updated 18/03/14 Page 1 of 1. As constructed lodgement Planning Environment Contributed Assets City Development PO Box 5042 GOLD COAST MC QLD 9729 P 5582 8052 F 5582 8241 E petcas goldcoast. qld. gov*au W cityofgoldcoast. com*au Please use BLOCK LETTERS and complete all details in full Privacy statement Council of the City of Gold Coast Council is collecting your personal information in accordance with Sustainable Planning Act 2009 SPA in order to issue an approval for your application* Your participation is voluntary. The information will only be used by authorised Council officers for the purpose of assessing your as-constructed application and ensuring our records are accurate. Your information will not be given to any other person or agency unless you have given us permission or we are required by law. As constructed lodgement Planning Environment Contributed Assets City Development PO Box 5042 GOLD COAST MC QLD 9729 P 5582 8052 F 5582 8241 E petcas goldcoast. qld. gov*au W cityofgoldcoast. com*au Please use BLOCK LETTERS and complete all details in full Privacy statement Council of the City of Gold Coast Council is collecting your personal information in accordance with Sustainable Planning Act 2009 SPA in order to issue an approval for your application* Your participation is voluntary. qld. gov*au W cityofgoldcoast. com*au Please use BLOCK LETTERS and complete all details in full Privacy statement Council of the City of Gold Coast Council is collecting your personal information in accordance with Sustainable Planning Act 2009 SPA in order to issue an approval for your application* Your participation is voluntary. The information will only be used by authorised Council officers for the purpose of assessing your as-constructed application and ensuring our records are accurate. The information will only be used by authorised Council officers for the purpose of assessing your as-constructed application and ensuring our records are accurate. Your information will not be given to any other person or agency unless you have given us permission or we are required by law. As constructed lodgement Planning Environment Contributed Assets City Development PO Box 5042 GOLD COAST MC QLD 9729 P 5582 8052 F 5582 8241 E petcas goldcoast. qld. gov*au W cityofgoldcoast. com*au Please use BLOCK LETTERS and complete all details in full Privacy statement Council of the City of Gold Coast Council is collecting your personal information in accordance with Sustainable Planning Act 2009 SPA in order to issue an approval for your application* Your participation is voluntary. The information will only be used by authorised Council officers for the purpose of assessing your as-constructed application and ensuring our records are accurate.

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