07/0924 - Op Works - Transport Type 5 - Domestic Marine [As Published] · 142007.924

Part A, Version 2.4, 29 May 2006

 

 

The completion of all applicable questions on Part A is mandatory for all applications. Part A must be accompanied by the completed IDAS Assessment Checklist if
Tequired, and by one (1) of more other completed parts of the Form as required. For more information on the parts of the Form refer to www.ipa.gld.gov.au.
Any information requested in the form may be provided in an attachment to the application. For further information about completing the following details, refer to Guide 1.

 

 

 

 

 

 

 

 

 

 

 

 

 

Description of land 1. Street address: fnciudinghouse number, street name, suburb/ocality name & postcode) (if applicable)
Allland the subject of the application, must be ° _
identified. However a description ofthe tnd snot Lit The. Promontry, NOO4YVILLeE 4st
- required in relation to a mobile or temporary y sy * + -
Environmentally Relevant Activity (ERA), 2. Name of water body or watercourse, within whicirthe development is proposed: (if applicable)
Advice for completing Q2 - 02 applies if TES
development Is proposed within a water body or LN Oce.A dal aA Ses: - |
@ watecourse. 3. _Loton pian description (eg. Lot 123 on RP 4567) / GPS coordinates:
Advice for completing Q3 - Most land can be
identffed by a lt on plan description, These detais | 214A V/0L4574 |
can be obtained from ttle documents or through the ae . .
local government, 4, The above description is for: (tick applicable box)
However, ite tandon wih the devetopren is t C1 (i) the fand-on which the developments proposed; or
he covlopret is ropased in ter cae fe ii) the land adjoining the water body or watercourse, within which the development is
watercourse) rove = on tr proposed; or
a aicingtloomt ‘and; of te (fii) the water body or watercourse.
GPS coordinates where there is
@ axfoningfadiocent ord (eg. in Moreton Bay), §. Shop / tenancy number: 6. Storey / level: 7. Total area of land: (m? or ha):
Advice for completing Q7 - Q7 does not apply if the | | [ | [ |
development is within a water body or watercourse,
See Ee EE ptigcrmataee. | Local government area in which the land is situated: (ag. Esk, Hervey Bay, Woocoo ete) (if applicable)
Note: Areas below high water mark are not within a .
Hote teas teow ih water mak awmatwitinag | I NINOS A COUNICAL
Local Government Act 1993. 9. Port authority for the strategic port land or strategic port land tidat area on which the
Advies for comptetina Q9 - 09 applies i development is proposed: (eg. Port of Brisbane, Port of Townsville) {if applicable)
development is on strategic port land or a strategic "189 i
port tand tidal area. For more details refer to Guide 11 i

 

 

. Existing use of the and: (eg. vacant, single house, shop etc.)
[SINGLE HOKE |

. Proposed use of the land: (eg. 6 unit apartment building, 30 lot residential subdivision, ERA for aquaculture in
ponds with a total area of 7 ha for which wastes are released into waters etc).

2. Other parts of Form 1 completed as part of this application: (eg. Part 0, Part I, etc)

fe, CREC. AST

 

 

 

 

 

   

 

. Applicant's name: 15. Contact person:
mest Noosé Jerry Bupess}] [EMMA PEED
When signing and todat i this ai lication 14. Contact number: 16. Facsimile number/e-mail address:
iomalon proved cect The axsesarent [(QU0KI3IS2 ] ~feees4¢so

 

manager, any referral agency & the Chief Executive
{where applicable) wil rely on this information wnen | 17. Postal address:

ing and deciding the application. =
ieatatbaonn commen | LO BOx 2AYNOCEAVILLE 4566
Aust be shawn, 18. Signature: 7 19._ Date:

Ga pia
(PF