10/0916 - Preliminary Building Approvals [As Published] · 172010.916

 

OO

 

 

 

 

 

(J No

Yes - complete either table D, table E or table F as applicable

 

Table D (note: do not complete this table if lodging the application on-line using Smart eDA)

 

 

Name of owner/s of the fand lan James Gifford Martin

 

We, the above-mentioned owner/s of the land, consent to the making of this application.

Signature of owner/s of the land See, stood ,

Date .

 

 

 

 

 

Table E

 

 

 

Name of owner/s of the land

 

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

 

Table F 4

 

 

Name of owner/s of the land

 

 

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

 

 

9."Does the application involve.a state resource?:(e.9- the application involves state land,
2 the notes at, the end of this form forr more informatis in)

    
 

taking:quarry

    

 

No [Yes - complete table G

 

 

 

10. Identify If any of the following apply to the premises (tick applicable. box/es) .

 

 

{ _ adjacent to a water body, watercourse or aquifer (e.g creek, river, lake, canal) - complete table H
(J __ onstrategic port land under the Transport Infrastructure Act 1994 - complete table |

LJ ._ ina tidal water area - complete table J

  
 

 

 
 

jents on the premises?. (e.g. for, vehicular acc

 

 

 

{XJNo []Yes - ensure the type, location and dimension of each easement is included in the plans submitted

 

Application Details - IDAS form 4
Version 1.0 18 December 2009