Development Permit part 1 of 1 · OPW12/0412

     DDD
Table C-premises coordinates (appropriate for development in remote areas, over part of a lot or in water e.g. channel
dredging in Moreton Bay)

Coordinates                                                                Zone        Datum               local government
(note:place each set of coordinates in a separate row)                     reference                       area   (if applicable)

Easting           Northing         Latitude           Longitude


                                                                                        D GDA94
                                                                                        D WGS84
                                                                                        D other

                                                                                                                  ~
                                                                                                                             ’"


5. Total area of the premises on which the development is proposed (indicate hectares or m2)
                                                                                                                                    011




    2W\lL
6. Current usels of the premises (e.g.vacant land, house, apartment building, cane farm, etc.)                           ~

                                                                                                                              ,’"    ~




    HoV\~         ~




7. Provide a brief description of the proposal (e.g.six unit apartment building, 30 lot residential subdivision etc.)



 10     (’t.fN\ovt +~ +Veil                              O\A_\(
                                                                   ~rlt.tJ4Id          (Ab    ,f ""~s ,l"o-rV!
-+00 b,~                                                                           C(.,d
i      t-\f


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



D       No


[21’ Yes-complete either table D, table E     or table F as   applicable


Table D


Name of ownerls of the land
                                              )e,     2JI\.Ct..,~      J
                                                                            YCA’’’’        C~Vt
I/We,the above-mentioned ownerIs of the land, consent to t          making of this application.

Signature of ownerIs of the land
                                                                                  ~                .




Date
                                          \ofro 1’2-0/2-
                                                     (




              3                                                                              Application details-IDAS form 1
                                                                                               Version 1.0 18December 2009