001A7F18.001

INTEGRATED PLANNING ACT 1997                                                                                             Part A, Version 3.1, 3 March 2008
:         ,AND/OR
           Table C   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            :     .                                                           .
                                         (Note: place each sel of coordinates in a separate row) °° Zone                             Local government area .
          -                                                                               = vena
                                                                                          [” wose4
                                                                                          [~ 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 applicable)
           Table D   Complete if the premises are adjacent to or associated with a water body, watercourse or aquifer (e.g. river, creek, lake, canal)
                                              a              ;       Name of water body, watercourse or aquifer (ifknown)                             my
                    a
           Table E    Complete if the premises are on Strategic Port Land under the Transport Infrastructure Act 1994
                             4...       Loton plan description for strategic portiand. ..    -] ,.*      ...   *., PortAuthorityforthelots» 9
   ©       Table F    Complete if the premises are in tidal water
                                ». Name of local government for the tidal area (if applicable)... |. ~ Namie of port authority for the tidal area (ifapplicable)
                     sD
           3,    Indicate the total area of the premises on which the development is proposed: (Note: The total area may include land both above and below water)
                             ae ~~ Total area ‘of premisés ARLE oarle            Re
                 2,874.00           [x]m? [_] hectares       (Tick applicable unit)
           Existing use of the premises -                  Te          Pu        i CAR      ORT dh es St naed co tegen ep cage thse  he pig    Bae        cea     |
           4.    Current use/s of the premises: (e.g. vacant land, house, townhouses, apartment building, shop, service station, school, sugar cane farming etc.)
                         [mee OOSOSOSSOSOSCSCSCSCSC“CSSOCSCSCSCSC‘C*d
            5.   Are there any existing easements on the premises? (e.g. for vehicular access, electricity, overland flow, water etc.)?
                 [_] No           Yes - Ensure the type, location and dimensions of each easement are included in plans, submitted with the application
           (Proposal details :              ow                              ee     we                     =                 ot                                .   |
  O         6. _ Brief description of the proposal (e.g. 6 unit apartment building, 30 Jot residential subdivision, a bore, aquacutture)
            Operational works associates with Reconfiguration of Lots

            7.    Does the poposal include new buildings or operational work (including any services) on the premises?
                [) No             Yes - Ensure the nature, location and dimensions of the proposed works are included in plans, submitted with the application
           ‘Resource entitlement (if appticable) _- further information is provided in-the advice section at the end of the form "               eB               J
                   TNC           POEL 2's:                =                                                                                     +
            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.)
                      No - Goto a9        [| 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.