Development Application part 1 of 2 · OPW12/0084

Table E


Name of owner/s of the land               I
oThe owner’s written consent is attached       or will be   provided separately to the assessment manager




Table F

Name of owner/s of the land               I
o By making this application, I, the applicant, declare that the      owner has   given written consent to the making of the
application.


                                                                              involves state land, or taking quarry materials.
9. Does the application involve a state resource? (e.g.the application
Refer to the notes at the end of this form for more information)



~ No                                o Yes-complete table G

Table G-state owned resources (provide details for each state resource in a separate table)

Nature of state-owned resource




Nature of evidence required (tick the

applicable box and attach a copy of the          0 Evidence of        an allocation   of, or an entitlement to, the resource
evidence to this form)


                                                            the chief        executive of the department administering the
                                                 0 Evidence is satisfied the
                                                          resource                    development is consistent with an allocation
                                                         of, or an entitlement to, the resource


                                                 0 Evidence the chief executive of the department administering the
                                                          resource is satisfied the   development application may proceed in the
                                                          absence of an allocation of, or an entitlement to, the resource



10.   Identify if any of !he following apply to the premises (tick applicable box/es)


0’ adjacent to water body, watercourse
                      a                         or   aquifer (e.g.creek, river, lake, canal)-complete table H

o       on   strategic port land under the Transport Infrastructure Act 1994-complete table 1

o in tidal water area-complete table J
             a




Table H          Name of water body, watercourse or aquifer


                  Noo<>A        \"-lC~



                 4                                                                             Application deta l_t;-IDAS form 1
                                                                                                 Version 1.0 18 December 2009