Development Application part 1 of 2 IDAS Forms

25/09 2013 15:08 FAX 0754852274                                                            FRALEY                                                                                                  ~006




          Table F-premlses coordlnate$
                                           (ApPropri~tefO( development in remote areas, over part of a lot or In Water
                                                                                                                       not
          adjoIning or adjacent to land e.g. channal dredging in Moreton
                                                                         Bay.)(Attach 8 separate schedule if there /s Insufficient
          space n this table.)

          Coordinates
                                                                                                                        Zone                  Datum                        Local government
         (Note:place each set of coord/nates n a
                                                 separate                                      row.)                    rafatence                                          area    (if applicable)
          Eastlng                 Northing                    Latitude                      Longitude

                                                                                                                                              0 GDA94
                                                                                                                                              0 WGS84
                                                                                                                                              0 other
  -      4:T       ta,J ’.~.. fih{pr~:mi~..ii’C? ’i ""hiGh t~ ’d ’V !dpijfeh                                       p’rQ ~,s9d (iridicate !$qct re ’metres)                                        ..   .’
                                                                                                                                                                                                                   "




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         r:6      No       0 Yes-provlde details below
         Usl of approval reference/s
                                                                                         Date approved (dd/mm/yy)                                      Date approval lapses
                                                                                                                                                                                           (ddlmm/yy)


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                                          .
                                                                                                              ~   to~~t s.at the end of thle fof(n ~or m6ri nfomi ~ori.) ’;                                 ....


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        ~ No

        o Yes-complete elth$r Table G,Table H or Table I as applicable

        Tabl G

        Name of ownerls of Ihe land

        lIWe, the above-menlloned ownerls of the land, COMent to the
                                                                                                                  making ofthis application,
        Signature of oWnerls of the land


        Date


     Table H

        Name of ownerfs of the land

     oThe owner’s written consent la attached or will be provided
                                                                                                                separately to the aSSSsment manager

    ~blel
    Fame of owner’s of the land                                      [                                                                                                        :
    ~
                                                                                                                                                               IDAS form 1-Applloa/ion cJ$tal7s
                                                                                                                                                                 VersiQn 2 017Decembet 2012