0015D13F.001

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  ~         INTEGRATED PLANNING ACT 1997                                                                                       Part A, Version 2.4, 29 May 2006
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         .      ‘The completion of all applicable questions on Part A is mandatory for all applications. Part A must be accompanied by the completed IDAS Assessment Checklist if
                    required, and by one {1) or more other completed parts of tha Form as required. For more information on the parts of the Form refer to www.ipa.qid.gov.au.
              Any information requested in the form may be provided in an attachment to the application. For further information about completing the following details, refer to Guide 1.
             Description of land                     1.   Street address: fnctudinghouse number, street name, suburtvlocalily name & postcode) {if appficable)
             teed Hower 2 decrpion fh land 0              Wnts (Ze 5 ounseehker CIAL. Mik avi lle                                                        4s
            Alt land the subject of the application, must be                 ,                               2
@            Ee onnentty Retsan avy (ERA             2.   Name of water body or watercourse, within which the development is proposed: (if appficabie)
            nade atin 2-2                                 NOEGWAHS
            development is proposed within a water body or                 —                                       -
            watecourse.                              3.   Loton plan description (eg. Lot 123 on RP 4567) / GPS coordinates:
             ented Iya oe pen bya on pn despa, Tee eas   hoff l¢¥n On G7F HAAS
                 for     et     - Most land can be
            Ce comanent ue cesumenscrrowwh         | 4    The above description is for: (ck appicabie box)
             However, if the land on which the development is ae the land on which the development is proposed; or
             Po     eee ne a intaterboavar                    (ji) the land adjoining the water body or watercourse, within which the development is
             watercourse) provide -                               proposed; or
             0 agadomote                                  [71 (iii) the water body or watercourse.
             ® sgotcnadjacet lard (eg in Morton Bay). 5.  Shop / tenancy number:        6.   Storey / level:            7.   Total area of land: (m? or ha):
             waremameatvmemmyem)                      [                         }             fd}                          EC
             development is within a water body or watercourse.
             euie for cas tating ae | erment ree     8.   Local government area in which the land is situated: (eg. Esk, Hervey Bay, Woocoo etc.) {if applicable)
            now meteoniinwanrmrvomiwtine | [VOSA Wire lOWal                                                                                          d
            focal government's area unless provided for under the            a                                                          -
             Local Government Act 1993.   /          9.   Port authority for the strategic port land or strategic port land tidal area on which the
           sore A         casei ;                         development is proposed: (eg. Port of Brisbane, Port of Townsville) (if applicable)
@           Prdagsatletails    fy                \ 10.    Existing use of the land: (eg. vacant, single house, shop etc.)
             ttAhereig                    iis may be
             [                                        1.  Proposed use of the land: (eg. 6 unif apartment building, 30 Jot residential subdivision, ERA for aquaculture in
                        13 JUL 2007             | H ” ponds with a total arpa of 7 ha for which wastes are released into waters etc).
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              O ter g plicable pars BFF Im DA        12.  Other parts of Form 1 completed as part 6f this application: (eg. Part D, Par, etc}
             Part Avgfust afwass be  led b
            when a partt cord Nay bop fefer to puide 4.
             Applicant detalls                       13. Applicant's name:                  .           15.  Contact person:        -
                   aymgemmememe™ |                           Whnca Te Ky             Ba     Ve
             sppicant ned not be the omer ote land        UNA          fe ky Bui Bers                                             CA
            When signing and tedaing this appiication 14. Contact number.     \/                        16.  Facsimile number/e-mail address:
             The appficant Is responsible for ensuring the
             information provided Is correct. Tre een                                                                /         c>      S
             manager, any referral agency & the Chief Executive
             (whore 2potcabe) wil ely on this Information when | 17. Postal address:
            {the applicant ig a company - a contact person  KO FOx &* iH                        Oo C                                      —
            ithe anolcat isa company acor
             must be shown.                          48.  Signature:                          /7                      19.  Date;
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