00157AD5.001

v         INTEGRATED PLANNING ACT 1997                                                                                                           Part A, Version 2.4, 29 May 2006
                                            Form        1   Development Application                                                                                   idas

                 The completion of atl applicable questions on Part A is mandatory for all applications, Part A must be accompanied by the completed IDAS Assessment Checklist if
                      required, and by one (1) or more other completed parts of the Farm as required. For more information on the parts of the Form refer to www.ipa.qld.gov.au.
               Any information requested in the form may be provided in an attachment to the application. For further information about completing the following details, refer to Guide 1.
             Description of land                            1.    Street address: fncludinghouse number, street name, suburb/locality name & postcode} (if applicable)
             identified. However, 2 description of the fand is nat             va ny S"                     Ah COB                A,     CCI
                 .  .     5         il                                                                         *  .      .                        °                     yi
             Ennis Relevent Actes CRAY                      2.    Name of water body or watercourse, within which the development is proposed: (if applicable)
             development is proposed within a water body or                           —                                              -
 @          watecourse.                                     3.    _Loton plan description (eg. Lot 123 on RP 4567) / GPS coordinates:
             Advice for completing Q3 - Most land can be
             identified by a lot on plan description. These details  -) &         LO        OK          SP          72 S72? .
             can be obtained from title documents or through the                     soe
             local government                      9        4.    The abave description is for: (tick applicable box)
             However, if the land on which the development is         (i)  the land on which the development is proposed; or
              roposed doas nof have a lot on plan description fie.     2                 vo                                              taps     .                        ‘
             he dovolopmestc proposed ine mater bod or            C1 (ii)  the land adjoining the water body or watercourse, within which the development is
             watercourse) provide —                                         proposed; or
              i) the tot on plan description for the                   ese
             0 roninatediooont ed or                              C1 (iii) the water body or watercourse.
              ii} GPS coordinates where there is no
             " adjoining/adjacent land (eg. in Moreton Bay). 5.   Shop / tenancy number:              6.    Storey / level:                7.    Total area of land: (m? or ha):
             development is within a water body or watercourse.                                                                                            a
             Advice for completing Q8 - 8 applies if                                          :     '              ie  gl      '                                    .     .
             development is within a local goverment area.  8.    Local government area in which the land is situated: (eg. Esk, Hervey Bay, Woocoo etc.) {if applicable)
             local government's area unless provided for under the             -                   ,                        -
             Local Government Act 1993.                     9.    Port authority for the strategic port land or strategic port land tidal area on which the
             Advice for completing Q9 - Q9 applies if                             i             ‘              F                    itt) fi    p
             development is on strategic por land ora strategic   development is proposed: (eg. Port of Brisbane, Port of Townsville) (if applicable)

             Proposal details                               10.   Existing use of the land: (eg. vacant, single house, shop etc.)
@            provided in an attachment to the application.                f        AS 7:
                                                            11.   Proposed use of the land: (eg. 6 unit apartment building, 30 lot residential subdivision, ERA for aquaculture in
                                                                  ponds with @ total area of 7 ha for which wastes are released into waters etc).

             Other applicable parts of Form 1               12.   Other parts of Form 1 completed as part of this application: (eg. Part D, Part J, etc)
             completed parts of Form 1. For information about
             when a part of Form 1 may apply refer to Guide 1.
             Applicant details                              13.   Applicant's name:                                     15,   Contact person:
             Clearly identify who is making the application, The                                                                Spohr Cri les pie -                          |
             applicant need not be the owner of the land.              XZ  &               F.                                      MP EUO A      ae
             When signing and lodging this application      14.   Contact number:                                       16.   Facsimile number/e-mail address:
             rfertaon word is cored. Ta        assssr             | S479 S34/                                    |) ([email protected]
             information provided is correct. The assessment               a                                                     C4       C?   (a   CYICO              Oo      Cale
             manager, any referral agency & the Chief Executive                                                                         or,
              (where applicable) will rely on this information when 17. Postal address:
              We apncantis   a   compan -o con                    70 Le. S77A, Neroahidore KC, 8 ASS.
              If the applicant Is a company - a contact person                 Ads                          POR 2G ANE                       SDS          Cs              cS
              must be shown.                                18.   Signature:                                                             19.  Date:

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