MCU16/0036 Development application - 52 Gevers Rd, Black Mountain

                                                                                 Department of Infrastructure, Local Government and Planning



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

~      No         D     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.)

D No
D Yes-complete           either Table F, Table G or Table H as applicable


Table F

Name of ownerls of the land                      Ian McGillivray   and Linda McGillivray       (nee Wandell)

IMle, the above-mentioned       ownerls of the land, consent to the making of this application.

Signature of ownerls of the land


Date

Table G

Name of ownerls of the land                  I
D The owner's written consent is attached or will be provided separately to the assessment manager.
Table H

Name of ownerls of the land                  I
D By making this application, I, the applicant declare that the owner has given written consent to the making of the application.
7.     Identify   if any of the following        apply to the premises       (Tick applicable box/es.)


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

D On strategic port land under the Transport Infrasfructure Act 1994--almplete Table J
D      In a tidal water area-complete            Table K

D On Brisbane core port land under the Transport Infrastructure Act 1994 (No table requires completion.)
D On airport land under the Airport Assets (Restructuring and Disposal) Act 2008 (no table requires completion)
D      Listed on either the Contaminated Land Register (CLR) or the Environmental
       the Environmental Protection Act 1994 (no table requires completion)
                                                                                                     Management Register (EMR) under



Table I

Name of water body, watercourse or aquifer




                                                                                                            IDAS form 1-Applicalion delails
                                                                                                                Version 4.2-3 August 2015