Development Application IDAS Forms 1 & 6 - OPW12/0510

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           DO

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

 D material change of         use of   pre,mises

 o building work
 G21 operational work
 o reconfiguring lot     a




 2.   What type of approval is being sought?                              "




 o         development permit           5ZI   preliminary approval     0 both-provide details below

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3. Is the    pplication for a mobile and temporary environm ntally relevant activity (ERA)?                                   I


 ~ No
 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




14. Loc tioh of the premises (complete table B and/or table C as applicable. Identify each lot in a separate row)           il<\)
        .
            -     .
                                                                                          .                                         i!i!,




Table B-street address/lot for the premises or street address/lot on plan for the land adjoining or adjacent to the
 premises

        o street address/lot     on the   plan

        o 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
                                                                                                  (e.g. Logan, Cairns)
           Street     Street name and official suburb/     Post-     Lot no.     Plan type
 no.        no.       locality name                        code                  and plan no.


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                  2                                                                           Application deta ls-/DAS form 1
                                                                                                Version 1.0 18 December 2009