Development Application for permit to damage vegetation - OPW13/0600

    Table F-premises coordinates (Appropriate for development in remote areas, over part of a lot or in water not
    adjoining or adjacent to land e.g. channel dredging in Moreton Bay.) (Attach a separate schedule if there is insufficient
    space in this table.)

    Coordinates                                                                             Zone                               Datum                Local government

    (Note: place each set of coordinates in a separate row.)                                reference                                               area   (if applicable)

    Easting        Northing                   Latitude        Longitude

                                                                                                                               o   GDA94

                                                                                                                               o   WGS84

                                                                                                                               o   other



    4. Total area of the premises on which the development is;proposed (indicate square
                                  >-
                                                                                   .




                                                                                        "’,,’8-,~                        ’’:
                                                                                                                                           mefre’&)’
                              ~




    5. Current use/s of the;’             ’i’ses (e.g. vacant land,
                                               .
                                                                      house,~~~hm:~~Qt,building,
                                                                             ".,.k~’b   "
                                                                                            {:;;,-;,’COi’i",’-’-,
                                                                                                                                cane   farm’etc.)
                                                                                                                                               ’.




    6. Are there   anyiiMlr            pprovals (e.g. a preliminary’
                                       ~<#’
    mandatory requiremeDt..

    o      No       o       Yes-provide details below


    List of approval reference/s                               Date approved (dd/mm/yy)                                                Date approval lapses (dd/mm/yy)




    7. Is owner’s c hse~                        ,for this application?e ,e                                          at the end of this form.



    o      No


    o      Yes-complete either Table G, Table H or Table I as applicable


    Table G


    Name of owner/s of the land


    I/We, the above-mentioned owner/s of the land, consent to the making of this application,

    Signature of owner/s of the land



    Date



    Table H


     Name of owner/s of the land


    oThe owner’s written consent is attached or will be provided separately to the assessment manager


I   Table I

     Name of owner/s of the land


    (!                                                                                                                                       IOAS form 1-Appficalon details
                                                                                                                                              Version 2.0 ’17 December 2012