09/1654 - Preliminary Building Works Assessable Against the Planning Scheme [As Published] · 172009.1654

 

  
 

Part A. Version 3.1, 3 March 2008
watercourse or aquifer (e.g. river, creek, lake, cana)

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Table E Complete if the premises are on Strategic Port Land under the Transport infrastructure Act 1994

   

         

 

   

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3. _ Indicate the total area of the premises on which the development is proposed: (Note: The total area may include fand both above and below “@®
5 Seo tnt ie, Be
(Tick applicable unit)

 

  
  

 

 

 

 

 

  

FEcere tery caneenmarenn ins at SRK apa“ B ance epee SEH i; ™ vase STE ae . aye
(Existing use of the premises Mt a al ee ee

4. — Current use/s of the premises: {e.g. vacent land, house, townhouses, epartment building, shop, service station, school, sugar cane farming etc.)

 

  

 

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5. Are there any existing easements on the Premises? (e.g. for vehicular access, electricity, overtand flow, water etc.)?

4 No Yes - Ensue the lype, location and dimensions of each easement are included In Plans, submitted with the appication
Proposal detalles WS ATES” BE oy ens
Proposal details. at SESS SE ae st s
6. Brief description of the proposal (e.. 6 unit apartment building, 30 fot residential subdivision, @ bore, aquaculture)

   

 

Addition of roof to back verandah and front entry

 

 

 

7. Does the paposal include new buildings or operational work {including any services) on the premises?

[X] No

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O Yes - Ensure the nature, iocation and dimensions of the proposed works are inciuded in plans, submitted with the application

   

   

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Resource entitlement (i apg SPoouided in he edieg section ft the end ofthe fom“ wang ey

   

8. Does the application involve taking or interfering with a State resource and therefore require a resource entitlement? (e.g. the application
involves State land (leased and freehold), declared Fish Habitat reas, taking quarry material, taking or interfering with water under the Water Act 2000, efc.)

No - GoioQ¢ O Yes - Complete Table G - provide details for each evidence required ona saperaié row, ifapplicable. Evidence of resource
ahocation or entitlement must be submitted with the application. You do not need to answer O9 - goto the next section
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plleable).~ fur ef infor alion 13 provided in tho'adi Ogat ine end of i 5 . fay
9. Complete Table H for applications involving a material change of use; teconfiguration of a lot; work on land below high-water mark and
not within a canal as defined under the Coastal Protection and Management Act 1995, or work on rail corridor land defined under the

Transport Infrastructure Act 1994 - provide details for each ‘Owner On a Separate row, OF on an étiachment to this form if applicable

  
         

     

 
  
  

  

 

    

Table H

 

or iat on plan description)”

 

   

1 Daniel John Casey 12 Piper st. Peregian Beach 4573, QLD. 13/11/2009

 

 

 

 

 

 

 

* Owner's signature cannot be provided on the form if you intend to submit the application electronically. Owner's consent musj/e provided 6 the ASsessment manager on an
attachment containing appropriate written documentation of the owner's consent. If the owner is a company, $127 of the rations Act (Cwealth) details how a
company may sign as owner. Templates for the provision of owner's consent are avaiable on the IPA website .