001AD296.001

INTEGRATED PLANNING ACT 1997                                                                                 Part A, Version 3.1, 3 March 2008
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                                                              Part                A                             Cray SS
                                                         Common details                                                COOLNTTITOY                   )
         OTE: Answer all questions unless directed to go to a particular question. Refer to the end of the form for advice on Ae GaAaR        A
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       IRpplicant deta    (he aptcan i the   person resporsiog or Mako Heaps prand pee not be he. owner of Iie Bind: The Nebo epee Rape eg
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        (iastng tas apfeaton ‘By odphg nk appre the Apple  Fiat the bigaOns a    eeporStiies resgyed by {bP hry develo    PSSA       BEAST:
        Le ay Artal as             aclu ts ol ni a                         NAEP                      helene
           Company/organisation name {if applicable) |Pile-It Pty Ltd ta Noosa Jetty Builders
        individual epplicant/Contact person (If there is more than one applicant, provide additional applicant details on an attachment to this form}
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           Postal address                PO Box 299, Noosaville. QLD 4566
            Contact telephone number | (07) 5474 3480                        Mobile phone number           0408 137 526
            Facsimile number             (07) 5474 3480                      e-mail address                [email protected]
         BETA of Iie    premises fe Melataoh     gh re cevnpmenks popcsed ele othe          Mead Oe      ll cya  nde a
         1.  Identify the premises by completing Table A, or Table 8 and/or Table C (ensure adequate information is given to identify the premises)
         Table A   Ifthe application is for a mobile and temporary Environmentally Relevant Activity (ERA), complete Table A only. Then go to Q2.
                         «LB SESE, Nate of cath        cal goverinent area in which the qoble and temporaly ERA s opesed to operate ui
          OR                                                                                                              .
         TableB    Street address for the premises (tick applicable boxes below and insert property description in the table. Identify each-lot in a separate row.)
O               (i)  {CL Street address / lot on plan for the premises (Appropriate for most applications including building applications): Of
                (ii) [XJ Street address /ot on plan for the !and adjoining or adjacent to the premises (Appropriate for development in water e.g. jetty,
                         pontoon etc) (Note: Loton plan details may be oblained from title documents, a ‘Rate’ notice, or from the focal government.)
                          ee a aneatet eects                 Se                            oo uy      er +s: Local government area (eg: Logari,,
                   TP Ts [saece me temic                                      (ese       for” fares [Senimconnemcns                              |
          AND/OR
           Table    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.)
                           TST EE                               ee gm dpiw ge a gp ec lei
                           “A         Note: place each sat of cnoediniates ha separate Con} : “Zone, ee . Daten      “hk Local governniént ares
                   | 1 |                                                                           [1] ocoass
                                                                                                   [_] wese4
                                                                                                   [_] 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)