1.	Before you lodge	
This form is required to apply for the approval of the Minister to carry out a project to which Part 3A of the Environmental Planning and Assessment Act 1979 (the Act) applies.
Before lodging this application, it is recommended that you first consult with the Department of Planning (the Department) concerning your project. 
A Planning Focus Meeting may need to be held for this project involving the Department, relevant agencies, council or other groups identified by the Department. If a Planning Focus Meeting is held, the Department will issue the Director-General’s requirements for the Environmental Assessment following the meeting.
Disclosure statement
Persons lodging applications are required to declare reportable political donations (including donations of or more than $1,000) made in the previous two years. 
For more details, including a disclosure form, go to www.planning.nsw.gov.au/donations.
Lodgement
All applications must be lodged with the Director-General of the Department of Planning, by courier or mail. An electronic copy should also be emailed to the assessment contact officer assigned to the project. 
NSW Department of Planning
Ground floor, 23–33 Bridge Street, Sydney NSW 2000
GPO Box 39 Sydney NSW 2001 
Phone 1300 305 695.
	
2.	Details of the proponent	
Company/organisation/agency
Norske Skog Paper Mills (Australia) Ltd Albury
	ABN
84 009 477 132	
 Mr 	 Ms 	 Mrs	 Dr	 Other	     	
First name
Ernie	Family name
Hacker	
Position
General Manager	
STREET ADDRESS	
Unit/street no.
117	Street name
R.W.Henry Drive	
Suburb or town
Ettamogah 	State
NSW	Postcode
2641	
POSTAL ADDRESS (or mark ‘as above’)
Private Bag	
Suburb or town
Lavington 	State
NSW	Postcode
2641	
Daytime telephone
02 6058 3111	Fax
02 6058 3000	Mobile
     	
Email
ernie.hacker@norskeskog.com
	
3.	Identify the land you propose to develop	
STREET ADDRESS (where relevant)	
Unit/street no.
117	Street or property name 
R.W.Henry Drive	
Suburb, town or locality
Ettamogah 	Postcode
2641	
Local government area(s)
Albury City Council	State electorate(s)
Albury	
REAL PROPERTY DESCRIPTION
Lot 21 DP 604181 in the Parish of Mungabarinna, County of Goulburn.
	
Note: The real property description is found on a map of the land or on the title documents for the land. If you are unsure of the real property description, you should contact the Department of Lands.  
Please ensure that you place a slash (/) to distinguish between the lot, section, DP and strata numbers. If the project applies to more than one piece of land, please use a comma to distinguish between each real property description.	
OR detailed description of land attached. 	
MAP: A map of the site and locality should also be submitted with this application.	
4.	Major project description and other requirements	
Provide a brief title for your project.
Biomass Boiler and Steam Turbine Generator 10 MW Base Load

PROJECT APPROVAL
If you are applying for approval of a project, include in the project title, all significant components for which approval is being sought. If the application relates to part only of a project, the project title should reflect this.
Is the application for approval of a project?								Yes		No
Is the application related to part only of a project?							Yes		No

CONCEPT PLAN APPROVAL
If you are applying for approval of a concept plan, include in the project title, all components for which approval ‘in concept’ is being sought. If the application also relates to approval of a project, a description of this should also be included in the project title.
Is the application for approval of a Concept Plan?							Yes		No
Is a project application being made concurrently for all or part of the project?		Yes		No

You are also required to provide a Project Description and address any matters required by the Director-General in accordance with section 75E or section 75M of the Act. Failure to do so may lead to your application being rejected.
Is a Project Description attached?										Yes		No
Does the Project Description include any additional matters required by the Director-General under section 75E or section 75M of the Act?										Yes		No

Note: An electronic copy of the project description is also required as all applications must be provided on the Department’s website. You should contact the Department on the correct electronic format.

	
ESTIMATED CAPITAL INVESTMENT VALUE
Please indicate the estimated capital investment value (CIV) of the project. The CIV includes all costs necessary to establish and operate the project, including the design and construction of buildings, structures, associated infrastructure and fixed or mobile plant and equipment (but excluding GST and land costs).

 $53 million     	
EQUIVALENT FULL-TIME JOBS
Please indicate the number of jobs created by the project. This should be expressed as a proportion of full time jobs over a full year. 	
Construction jobs (full-time equivalent)	100
	
Operational jobs (full-time equivalent)	8-10
	
5.	Approvals from State agencies	
Does the project require any of the following: (tick all that are appropriate)
	an aquaculture permit under section 144 of the Fisheries Management Act 1994
	an approval under section 15 of the Mine Subsidence Compensation Act 1961
	a mining lease under the Mining Act 1992
	a production lease under the Petroleum (Onshore) Act 1991
	an environment protection licence under Chapter 3 of the Protection of the Environment Operations Act 1997 (for any of the purposes referred to in section 43 of that Act)
	a consent under section 138 of the Roads Act 1993
	a licence under the Pipelines Act 1967
	
6.	Landowner’s consent or notification	
As the owner(s) of the above property, I/we consent to this application being made on our behalf by the proponent:	
Land
As per Section 3

Signature
     

Name
     

Date
     	Land
As per Section 3

Signature
     

Name
     

Date
     	

Note: Under clause 8F of the Environmental Planning and Assessment Regulation 2000 (the Regulation), certain applications for approval under Part 3A of the Act do not require the consent of the landowner, however, the proponent is required to give notice of the application: 
•	in the case of linear infrastructure projects, by notice in a newspaper circulating in the locality prior to the commencement of the public consultation period, 
•	in the case of mining or petroleum production projects, by notice in a newspaper circulating in the locality within 14 days of this application being made, 
•	in the case of critical infrastructure projects, to the owner of the land within 14 days of this application being made, and
•	in other cases, to the owner of the land at any time before the application is made.

	
7.	Political donation disclosure statement	
Persons lodging applications are required to declare reportable political donations (including donations of or more than $1,000) made in the previous two years. Disclosure statements are to be submitted with your application or request.
Have you attached a disclosure statement to this application?
	Yes
	No
Note: For more details about political donation disclosure requirements, including a disclosure form, go to www.planning.nsw.gov.au/donations.
	
8.	Proponent’s signature	
As the proponent(s) of the project and in signing below, I/we hereby:
•	provide a description of the project and address all matters required by the Director-General pursuant to section 75E and/or section 75M of the Act, and
•	apply, subject to satisfying clause 8D of the Environmental Planning and Assessment Regulation, for the Director-General’s environmental assessment requirements pursuant to Part 3A of the Act, and
•	declare that all information contained within this application is accurate at the time of signing.
	
Signature
     

Name
     

Date
     	In what capacity are you signing if you are not the proponent
     
	
	Name, if you are not the proponent