MCU17/0005 - IDAS Application - 113 Marara St Cooroy

                                                                              Department of InFrastructure, Local Government and Planning


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

o       No          o Yes-provide details below
List of approval reference/s                               Date approved (dd/mm/yy)                      Date approval lapses (dd/mm/yy)



6.       Is owner's    consent   required     for this application?       (Refer to notes at the end of this form Formore information.)


o       No

iii Yes-complete          either Table F, Table G or Table H as applicable


Table F

Name of ownerls of the land

I/We, the above-mentioned        ownerls of the land, consent to the rna

Signature of ownerls of the land
                                                                                        •
Date

Table G

Name of ownerls of the land                   I
o      The owner's written consent is attached or will be provided separately to the assessment manager.

Table H

Name of ownerls of the land                   I
o      By making this application, I, the applican~ declare that the owner has given written consent to the making of the application.


7.       Identify   if any of the following       apply to the premises      (Tick applicable box/es.)


f2a     Adjacent to a water body, watercourse or aquifer (e.g. creek, river, lake, canal)-complete                    Table I

o On strategic port land under the Transport Infrastructure Act 1994-complete Table J
o In a tidal water area-complete Table K
o       On Brisbane core port land under the Transport Infrastructure Act 1994 (No table requires completion.)

o On airport land under the Airport Assets (Restructuring and Disposal) Act 2008 (no table requires completion)
o the
  Listed on either the Contaminated Land Register (CLR) or the Environmental Management Register (EMR) under
       Environmental Protection Act 1994 (no table requires completion)

Table I

Name of water body, watercourse or aquifer




                                                                                                                IDAS form 1-Application details
                                                                                                                  Version 4.3-5 December 2016