Development Application - Part 1 of 2 - IDAS Forms 1 & 6 and Checklist - OPW13/0503

        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
                                                                                        D WGS84
                                                                                        D other
        4. T’otal area of the premises onwhich the development is proposed (indicate square metres)                       ~
                                                                                                                              ~
                                                                                                                     I~
                                                                                                                                  IJ"




    I   886m2




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




I       House




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

        x      No      D     Yes-provide details below

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




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


        X      No

        D      Yes-complete either Table G, Table H or Table I as applicable

        Table G

        Name of owner/s ofthe land


        IMle,the above-mentioned ownerls of the land, consent to the making of this application.

        Signature of owner/s of the land


        Date


        Table H


        Name of owner/s ofthe land


        D The owner’s written consent is attached or will be provided separately to the assessment manager

I       Table I


    4                                                                                               IDAS fonn 1-Application detaiJs
                                                                                                     Version 2.017 December 2012