Use this form to apply for an Exemption Certificate under section 72 of the Queensland Heritage Act 1992 for development on a Local Heritage Place (which is a place entered in a local government’s heritage register or identified as being of local heritage significance in its planning scheme).
An Exemption Certificate may only be issued for development at a Local Heritage Place that:
- will have no more than a minimal detrimental impact on its cultural heritage significance, or
- is permitted under a heritage agreement.
Note: an Exemption Certificate cannot be issued for a Local Heritage Place that is also a Queensland Heritage Place (which is a place entered in the Queensland Heritage Register under the Queensland Heritage Act 1992).
This is an online version of the Queensland Government form 160404 Form 3, Version 1 as provided by the Department of Environment and Heritage Protection.
The personal information collected on this form will be used by Brisbane City Council for the purpose of assessing your application. This information is required to be collected by the Queensland Heritage Act 2014. Your personal information will not be disclosed to any third party without your consent unless required or permitted by law.