Development Application part 1 of 2 · OPW12/0084

     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


                                                                                        0 GDA94
                                                                                        0 WGS84
                                                                                        0 other


                                                                                        hectares or m2)
 5. Total area of the premises on which t~,e de\,j~lopment is proposed (indicate



I 7<6~vv.. ’l-




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




I [.to\)S~
                                                                                          lot residential subdivision etc.)
 7. Provide a brief description of the proposal (e.g.six unit apartment building, 30



                         ~ON                     e;-x \"5. ’\’\Nb            :2.   oN -"5"’H<.e-t:T          c.Jt(l_p~
  ~<:ON~\                                 of=-

                                                             SSCNE:"Q..S                             10 NE:1N
                                D U At_. ’t>f2_l\J         ~~


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



 ~ No
                                               or table F as   applicable
 D Yes-complete either table D, table E

 Table D


 Name of ownerIs of the land


 I/We,the above-mentioned ownerls of the land, consent to the making of this application.

 Signature of ownerIs of the land



 Date




                 3                                                                          Application detatls-/DAS form 1
                                                                                                Version 1.0 18 December 2009