Development Application for permit to damage vegetation - OPW13/0009

                                                                                                                        \
                                                                                                                            .,




     Table F-premises coordinates (Appropriate for development in remote areas, over part of a lot or in water not
     adjoining or adjacent to land e.g. channel dredging in Moreton Bay.) (Attach a separate schedule if there is insufficient
     space in this table.)

     Coordinates                                                        Zone         Datum             Local government
     (Note: place each set of coordinates in a separate row.)           reference                      area   (if applicable)

     Easting       Northing          Latitude         Longitude

                                                                                      0 GDA94
                                                                                      0 WGS84
                                                                                      0 other

     4. Total area of the premises on which the development is proposed (indicate square metres)                                 I

     5. Current use/s of the premises (e.g. vacant land, house, apartment building, cane farm etc.)



                                                                                                          ,\
            ’vN\l.S           .




     6. Are there any current approvals (e.g.a preliminary approval) associated with this application? (Non-
     mandatory requirement.)

     0’No          0      Yes-provide details below

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




     7. Is owner’s consent required for this application? (Refer to notes at the end of this form for more information.)


     ~No
     0 Yes-complete either Table G, Table H or Table I as applicable

     Table G


     Name of ownerls of the land


     I/We, the above-mentioned ownerls of the land, consent to the making of this application.

     Signature of ownerls of the land


     Date


     Table H


     Name of ownerls of the land


     oThe owner’s written consent is attached or will be p rovided separately to the assessment manager


I:
     Table I


     Name of owner/s of the land
                                           I
 4                                                                                                IDAS form 1-Application details
                                                                                                    Version 2.017 December 2012