IDAS Form 1 - 30-32 Doonella Street, Tewantin (00011167)

 

5. Are there any current approvals (e.g. a preliminary approval) associated with this application? (Non-
mandatory requirement)

 

x] No [_]  Yes—provide details below

 

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

 

 

 

 

 

 

6. Is owner’s consent required for this application? (Refer to notes at the end of this form for more information.)

[-] No -

&X] Yes—complete either Table F, Table G or Table H as applicable

 

 

Table F

 

Name of owner/s of the land Serina Pty Ltd
#We, the above-mentioned owner/s of the land, congent fof fthe making of this application. _» Va

Signature of owner/s of the land (lei Mon AC
(@

Date

 

 

 

 

 

Table G

Name of owner/s of the land

 

 

im The owner's written consent is attached or will ixe provided separately to the assessmen: ane: 72r.

 

 

Table H

 

 

Name of owner/s of the land

 

CL] By making this application, |, the applicant, declare that the owner has given written consent to the -.aking of the application.

 

 

 

Identify if any of the following apply to the premises (Tick applicable box/es.)

Adjacent to a water body, watercourse or aquifer (e.g. creek, river, lake, canal)—complete Table |

On strategic port land under the Transport Infrastructure Act 1994—complete Table J

In a tidal water area—complete Table K

On Brisbane core port land under the Transport infrastructure Act 1994 (No table requires completion.)

On airport land under the Airport Assets (Restructuring and Disposal) Act 2008 (no table requires completion)

Oooogdgo IA]

Listed on either the Contaminated Land Register (CLR) or the Environmental Manageraé.+, 2.agister (EMR) under
the Environmental Protection Act 1994 (no table requires completion)

 

Table |

 

Name of water body, watercourse or aquifer

 

 

 

 

 

 

 

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