Application for permit to damage vegetation - OPW13/0074

    Table C-Additional aspects of the application (If there are additional aspects to the application please list in a
    separate table on an extra page and attach to this form.)

         D Refer attached schedule       g Not required


    2. Is the application for a mobile and temporary environmentally relevant activity (ERA)?


    G1       No-continue to question 3


    D        Yes-complete Table D and then go to question 6

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




    3. Location of the premises (Complete Table E and/or Table F as applicable. Identify each lot in a separate row.)


Table E-street address and lot on plan for the premises or street address and lot on plan for the land
                                                                                                            adjoining or
adjacent to the premises. (Note:this table is to be used for applications involving taking or interfering with water).
(Attach a separate schedule if there is insufficient space in this table.)
       ~      Street address and lot on plan (All lots must be listed.)

       D      Street address and lot on plan for the land adjoining or adjacent to the premises (Appropriate for
              development in water but adjoining or adjacent to land, e.g. jetty, pontoon. All lots must be listed)
Street address                                                           Lot on plan                   Local government area
                                                                         description                   (e.g. Logan, Cairns)
Lot         Unit       Street   Street name and official      Post-      Lot no.      Plan type
            no.        no.      suburb/ locality name         code                    and plan no.


i)         LC>"f" z.     1-1-   !7AYYlEW ~ IJ{~ /kAt. 45~7                 Lo.,. Z    $P 111..101     S"",,$L....e (OftH.   liZHSIr
ii)                                                                                                                         I


iii)

Planning scheme details (If the premises involves multiple zones, clearly identify the relevant zone/s for each lot in a
separate row in the below table. Non-mandatory.)
Lot        Applicable zone / precinct              Applicable local plan / precinct           Applicable overlay/s
i)

ii)

iii)




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                                                                                                     /DAS form 1-Application details
                                                                                                       Version 2.0 17 December 2012