09/0152 - MCU - Mulitple Housing Type 1 - Relative or Employee [As Published] · 132009.152

       

INTEGRATED PLANNING ACT 1997 Part A, Version 3.1, 3 March 2008

Form 1 Development Application

Part A

Common details

NOTE: Answer all questions unless directed to go to a particular question. Refer to the end of the form for advice on how to complete this form.

 

‘Applicant details (The Appicantis the person responsible for making the ‘application ar and need not be the owner of the fand.’. <The Appicantis responsibite: for ensuring. tha
‘information provided on the 1DAS Application Farm is correct. This information is refled Upon by the Assessment Manager and: any referral agencies when assessing and :

I ‘deciding this application.. By lodging this appication, the Appiicant incurs lhe obfigations. and responsibifties prescribed ¥ the IPA. Any. development permit or prekiminary
[approval that may be issued as a consequence of this applcation will be issued to the AppEcant). “Ae, x

 

 

 

Company/organisation name (if applicable) [Country & Coastal Certifiers |

 

 

Individual applicant/Contact person (if there is more than one applicant, provide additional applicant details on an attachment to this form)

Postal address [po Box 117 Caloundra Queensland 4551 |

@ Contact telephone number [07 5420 8611 Mobile phone number [ti‘Ss‘s*@S
Facsimile number 07 5420 8622 e-mail address [email protected]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1. Identify the premises by completing Table A, or Table B and/or Table C (ensure adequate information i is given fo identify the premises)
Table A If the application is for a mobile and temporary Environmentally Relevant Activity (ERA), complete Table A only. Then go to Q2.

 

 

 

 

 

 

[1
OR

TableB Street address for the premises (tick applicable box/es below and insert property description in the table. Identify each lot in a separate row.)
() (C] Street address / lot on plan for the premises (Appropriate for most applications including building applications); OF

(i) (2) Street address ot on plan for the land adjoining or adjacent to the premises (Appropriate for development in water e.g. jetty,
pontoon etc) (Note: Loton plan details may be obtained from title documents, a ‘Rate’ notice, or from the focal govemment.)

 

 

   
 
   

 

 

 

 

 

 

 

 

 

 

 

 

 

      

 

@ es Lot off plan.description |. :
« Unit | Street 3 Plan type. and {i
. Nb. | No t | Lt an Nombor|
1 61 LAKE FLAT ROAD BOREEN POINT 5 SP109944 SCRC - Noosa Area
AND/OR
Table Coordinates and/or a map of the premises (Appropriate for development in remote areas, over part of a lot, in water (e.g. channel dredging in Moreton
Bay) etc.)
Coordinates i | gow aan
tpn to nts pots) 5 Zone. _
a Az Reference | * ;
1 ([] pepags
CO weses
(D) Other -

 

 

 

 

 

 

 

 

 

 

2. Identify if any of the following apply to the premises by completing Tables D, E, or F. (Note: in most instances, the premises will not involve any of
the following characteristics, however some applications may involve one or more of these characteristics - complete only if appfcable)