Form 1 and 7 · REC14/0015

 

Suburb S77 KKDA £78 7
State | |Postcode VICTOR/A. 3 783

‘Country

 

 

 

 

 

 

 

 

Contact phone number O4 13 AAS 620

 

 

 

 

Mobile number (non-mandatory AS ABOVE
requirement)

 

 

 

 

Fax number (non-mandatory requirement)

 

 

 

 

 

 

 

 

 

 

 

 

Email address (non-mandatory rré Qa bug 13 Dgmail ~Can
requirement)
@
‘Applicant's reference number (non-
mandatory requirement)
1. What is the nature of the development proposed and what type

of approval is being sought?

 

 

Table A—Aspect 1 of the application (If there are additional aspects to the
application please list in Table B—Aspect 2.)

 

a) What is the nature of the development? (Please only tick one box.)

 

Material change | Reconfiguring a | Building work Operational

of use lot J work

b) What is the approval type? (Please only tick one box.)

 

 

Preliminary Preliminary Development
approval approval under permit
under $241 8241 and s242
of SPA of SPA Y/Y

 

 

 

 

 

ic) Provide a brief description of the proposal, including use definition and
number of buildings or structures where applicable (e.g. six unit
apartment building defined as a multi-unit dwelling, 30 lot residential
subdivision etc.)

A LOT KESIOLW PAK SUBLIVIS UAL,

 

 

 

id) What is the level of assessment? (Please only tick one box.)

 

Impact Code assessment

assessment /