0015367E.001

, 31/05 2007 THU 12:21          PAX                                                                                          @002/002               ,

                        INTEGRATED PLANNING ACT 1997       aan       a           CS                             ____  Pait, Verslon 24, 29 May 2006 1       4
                         Land owner's consent (appicsbe) | 20, Land owner's consent to the making of this application:                                      "4
                         sesame,                                                                                                                            |
                        wtition consent of the land the application ry   es   N      Ss.    .     Q       =  XQ          =     En     ae I.
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                             voor conserl fs pofrequied framobincr | =) WW -                     “                                                 |
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                  1.    -Resoureeentilement apace)    = | 21" Does this application Involve.a Slate resouree prescribed under a regulation (orthanfncvrg” =|
             ye          ‘eon 8.215) fo PA reqs evidoce of on + QuBAy meteda! on State Coastal land under the Coastal Protection end Management Act 1095)? 20° 2s
             ws         ‘ite spesoed Spouse           ra    s ENO: gotoqas     Teg OB JE] YES = g0 10 Q22        oye                       ‘
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                         Mi  aeine De recnesenmenest - 1 1) of the gitogation of, or entitement to, the resource — tach evidence and got a2stiy
 @           a          Rel  aches (oorba ktepeied ny    |  “SLT (i) the chief executve of the department administering the resource ie satisfled the = |
                         peiuirtetaoneenaonegeauas | :. °. cewlopmentts consstentwith           an location of or etlementtn th resource a»
                                    “7120 fi) the chief executive of the department adritnistering the resource Is satisfied the        -  . -
                                         ;            "  |   3, 2:4) development application may procged inthe absence of gn allocation of, or -. °.”
                               ake                             ty “ss@nbidement to, the resource -goloQag © 8    Se)
                        7 Rdtltateamaiing a           ci, [7 ExMetiOp Of thoirescuics entivement: =”              20             Ea
                        tended    ae thergnebaa, =      |  -  () Resour entiderient authority detais __—_(vi)Oflal stamp ofthe depertrient |           .
           .             ine   eat Depriantertitund f°                                                     _-Sdiinistering the resoutog ft             .
                        Resources, Minss and Water is mendetory where tie |. Serre                              applicable)                           :
                 __     Replication babes any water or rede qvamy “| (i) Name ofdelegatedfitcar-:
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             ‘v        eects a <o\                  2]       Wy Signature of delegated cfcer  <n                                                      .
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                         dep  ae SLY                                 piry date of evidencis fd aiptcabe)                  ae          Te              :
@              CG        reer              a              24, ‘Is the IDAS Assessment Checklist complated and attached to this application?
     ok                   a cad chacstdow\ act meee serteetonieivecs| = FVyEG  -"TETNO   -:the sesassitert cxanager may refuse to edodgt this epptcation on the gS
"Plant draydnge reports. “~:                              "*"":126, - Plansydraiinigelraports accompanying this application: “v2. Se               |.
            a            cpntopresdsembiesscum | | Pan/Orawing/RepotNumber                        |. ile                      |    bate |         |
                        manager, telemd agencies and ay person Viewing © f°: [Tn                                                    ee               PT
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   .                     PLEASE NOTE: The assessment manage may tse to accept an apeiaton tat th nef dgemant fst roid a apicable Rornadon requed by Part A foo do.
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  eo                     ist 476-00. | seecenn                 1 -b- 2007 Sines           al Mp onda Here || 7007/ fir |                            |
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