08/0745 - Operational Works - Landscaping [As Published] · 142008.745

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

2. _ Identify if any of the following apply to the premises by completing Tables D, E, or F. (Noto: 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 applicable)

 

Table D Complete if the premises are adjacent to or associated with a water body, watercourse or aquifer (ag river, creek, lake, canal)

 

" Name ‘of water body, watercourse or aquifer (if known)
1.

 

 

 

 

Table E Complete if the premises are on Strategic Port Land under the Transport Infrastructure Act 1994
~~ Loton plan description for Strategic port land‘ : : Port authority for the lot’ aaa

 

 

 

Table F Complete if the premises are in tidal water

 

Name of local goverment for the tidal area (f appicable) Name of port authority for the tidal area (if applicable)

 

 

 

1.

 

 

 

 

3. Indicate the total area of the premises on which the development is proposed: (No‘a: The total area may include land both above and below water)
Total area of premises (land on which the development is proposed) .

 

 

 

 

 

 

 

 

 

 

 

 

° Cl) im? (J hectares (applicable unit
[Existing use of the premises . ee ae a fn a wes ee _ ee a ime “4

4. Current use/s of the premises: (e.g. vacant and, house, townhouses, apartment building, shop, service station, school, sugar cane farming etc.)

Crea Atoe-

5. Are jhéfe any existing easements on the premises? (ag. for vehicular access, electricity, overland flow, water efc.)
No oO Yes - Ensure the type, location and dimensions of each easement are included in plans, submitted with the application

 

 

 

 

   

   

[Proposal getale OL Se Eo

6. Brief description of the proposal: (a.9. 6 unit apartment building, 30 Jot residential subdivision, a bore, aquaculture etc.)
AWAD SCHANG ,

7. Does the proposal include Aéw building work or operational work {including any services) on the premises?
oO No Yes ~ Ensure the nature, location and dimensions of the proposed works are included in plans, submitted with the application

 

 

 

 

 
  

Resource: entitlement (if applicable) ~ further information is provided in the advice section at the nd of the form ‘

  

 

 

8. Does the application involve taking or interfering with a State resource and therefore require a resource entitlement? (e.g. the application
involves State land (leased and freehold), declared Fish Habitat areas, taking quarry material, taking or interfering with water under the Water Act 2000, etc, )

0 - Ga to Q9 Oo Yes - Complete Table G - provide details for each evidence required on a separate row, if applicable. Evidence of resource allocation or
entitlement must be submitted with the application. You do not need to answer Q9 - go to the next section.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

     

Nature of State-owned resource @
Table G — |Nature of evidence required :
Allocation/entitlement a . “Dreith ao State Goverment Date of | Date of
reference number Name of authorising officer Position of authorising officer Department issue _| expiry
1.
rower nt fi theo is prod inte adie secon at ta erdafiiefomg >

9. Complete Table H for applications involving a material change of use; reconfiguration of a lot; work on land below high-water mark and not
within a canal as defined under the Coastal Protection and Management Act 1995; or work on rail corridor land defined under the
Transport Infrastructure Act 1994 - provide details for each owner on a separate row, or on an attachment to this form if applicable.

 

Date consent
was obtained

Table H Premises Owner's name/s Details of the premises owned

le ei *
and postal address (street address or lol on plan description) Owner's signature

 

 

 

 

 

 

 

 

 

* owner's signature cannot be provided on the form if you intend to submit the application electronically. Owner's consent must be provided to the assessment manager on an
attachment containing appropriate written documentation of the owner's consent. If the owner is a company, $127 of the Corporations Act 2001 (Cwealth) details how a
company may sign as owner. Templates for the provision of owner's consent are available on the IPA website .

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