Development Application part 1 of 2 Application Forms OPW13/0004

               ODD

     1. What is the nature of       development proposed? (tick all applicable box/es)

     o material change of use of premises
     o building work
     o operational        work

     o reconfiguring        a lot




    12.What type of approval being sought?
                                     is


     01’ development          permit        0 preliminary approval         D       both-provide details below




     3. Is the application for a mobile and temporary enVironmentally relevant activity (ERA)?


     ciNo
     o Yes-complete table A and then go to question 5

     Table A-name of each local government area in which the mobile and temporary ERA is proposed to
                                                                                                                operate




     4. Location of the premises (complete table B and/or table C as applicable. Identify each lot in a separate row)



    Table B-street address/lot for the premises or street address/lot on plan for the land adjoining or adjacent to the
     premises
            ~treet address/lot         on the   plan
            D street address/lot      on   plan for the land adjoining or adjacent to the premises (appropriate for development in
                water e.g. jetty, pontoon)


     Street address                                                      Lot on plan description      Local government area

     Unit     Street     Street name and official suburb/
                                                                                                      (e.g.Logan, Cairns)
                                                               Post-     Lot no.     Plan type
     no.       no.       locality   name                       code                  and plan no.
i
                                                                                      (2P
              ’~         Lcm’i~ ~                                       5Lt
                                                                                     1~(17~             S~~Co~f--.
                           (\\00~~ ~


                     2                                                                           Application details-IOAS form 1
                                                                                                    Version 1.018 Oecember 2009