OPW13/0072 Application for permit to damage vegetation 22 Noosa Parade Noosa Heads

                                                                                                                            11>      ’"




    Table F-premises coordinates (Appropriate for development in remote areas, over part of a lot or in water not
    adjoining or adjacent to land e.g. channel dredging in Moreton Bay.) (Attach a separate schedule if there is insufficient
    space in this table.)

    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


    4. Total area of the premises on which the development is proposed (indicate square metres)

         f
        ~Stl Ittf..   ’I...e_

    5. Current use/s of the premises (e.g.vacant land, house, apartment building, cane farm etc.)



                        HOLAji?


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

    []I No            D         Yes-provide details below

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




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


    D        No


    [g’" Yes-complete either Table G, Table H or Table I as applicable

    Table G


    Name of owner/s of the land                     bEN’IJ’~      Cffh P BE"LL-

    I~the above-mentioned owner"4 of the land, consent to the making of this application.

    Signature of owner;. of the land
                                                            ~
    Date                                               30 Ja.Vt~I~ .:2013

    Table H

    Name of owner/s of the land


    D The owner’s written consent is attached or will be provided separately to the assessment manager


I   Table I

    Name of owner/s of the land


    4                                                                                              IDAS form 1-Application details
                                                                                                    Version 2.017 December 2012