IDAS Form-1-application-details -signed

RES PSS ESS Re RES aE LE RS TNT ST a Pa a a ers

 

 

 

 

 

 

mandatory require

 

 

 

 

[1 No M  Yes—provide details below

 

 

 

List of approval reference/s Date approved (dd/mm/yy) Date approval lapses (dd/mm/yy)

Material Change of Use — Visitor 21 June 2007 Current application pending for

Accommodation Type 4 (Motel) Extension to Relevant Period
Lodged, September 2013.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
 

 

 

[] No

M  Yes—complete either Table F, Table G or Table H as applicable
Table F

Name of owner/s of the land Raphill Pty Ltd L A

 

We, the above-mentioned owner/s of thetand, dpnsenyt pf to the/ffaking of thisvapplication.

4.

Signature of owner/s of the land C4. FZ y C , 1:

Date 29 | ‘ \ tub

Table G ,

Name of owner/s of the land Y

 

 

 

 

 

 

 

| The owner's written consent is attached or will be provided separately to the assessment manager.

 

 

Table H

Name of owner/s of the land

 

 

 

L By making this application, |, the applicant, declare that the owner has given written consent to the making of the application.

 

 

 

 

 

 

 

 

 

 

Adjacent to a water body, watercourse or aquifer (e.g. creek, river, lake, canal)—complete Table |
On strategic port land under the Transport Infrastructure Act 1994—complete Table J
In a tidal water area—complete Table K

On Brisbane core port land under the Transport Infrastructure Act 1994 (No table requires completion.)

OOOOU

On airport land under the Airport Assets (Restructuring and Disposal) Act 2008 (no table requires completion)

 

Table |

 

Name of water body, watercourse or aquifer

 

 

 

Table J

 

Lot on plan description for strategic port land Port authority for the lot

 

 

 

 

IDAS torm 1—Application details
Version 3.0—1 July 2013