09/0077 - Preliminary Building Approval - Garage [As Published] · 172009.77

INTEGRATED PLANNING ACT 1997 Part A, Version 3.1, 3 March 2008

2. Identify if any of the following apply to the premises by completing Tables D, E, or F. (Note: in most instances, the premises will not involve any of the
following characteristics, however some applications may involve one or more of these characteristics - complete only if applicable)

Table D Complete if the premises are adjacent to or associated with a water body, watercourse or aquifer (e.g. river, creek, fake, canal)
Name-of water body, watercourse or aquifer (if known)

 

 

 

Table E Complete if the premises are on Strategic Port Land under the Transport Infrastructure Act 1994
~ Lot on plan description for strategic port land coo ~ Port authority for the lot

 

 

1.

 

Table F : Complete if the premises are in tidal water
Name of local government for the tidal area (/f applicable) Name of port authority for the tidal area (if applicable)

 

 

 

 

1.

3, Indicate the total area of the premises on which the development is proposed: (Note: The folal area may include land both above and below water)
Total area of premises (land on which the development is proposed)

lO/6PioO" Af hectares (~ apoicabie uni)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Existing use ofthe premises, oo yO cS

4, Current use/s of the premises: (0.9. vacant land, house, townhouses, apartment building, shop, service station, school, sugar cane farming etc.)

f ~ -

Pesidences

5. Are there any existing easements on the premises? (2.9, for vehicular access, electricity, overtand flow, water etc.) :
[LINo 1 Yes - Ensure the type, location and dimensions of each easement are Included in plans, submitted with the application

 

 

 

 

 

Proposal detaiis © men : ne ace

6. Brief description of the proposal: (e.g. 6 unit apartment building, 30 lot residential subdivision, a bore, aquaculture etc.)

Carnac rorhco Romeskbern+ Internal Renovation # Reloxatipn +

5

ae 4 Y q . 1.

7. Does the hropbsal include pew building work or operational work (including any services) On the premises? - me
O No '@S — Ensure the nature, location and dimensions of the proposed works are included in plans, submitted with the application

ee oem a meee ong n . : .

Resource entitlement (if applicable) further information is. in the advice section af the ahd of the fori

8. Does the application involve taking or interfering with a State resource and therefore require a resource entitlement? (e.9. the application
Stata Jand (leased and freehold), declared Fish Habitat areas, taking quarry material, taking or interfering with water under the Water Act 2000, etc.)

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No - Goto Q9 go Yes - Complete Table G - provide details for each evidence required on a separate row. if applicable. Evidence of resource allocation or
entitlement must be submitted with the application. You do not need to answer Q9 - go fo the next section,

    

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seen a MRE MOHD eR eanea Stag im ay ee om tiga me »

      

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Nature of State-owned resource
TableG Nature of evidence required
State Government Date of | Date of

Allocation/entitlement seh a ces
“reference number Name of authorising officer Position of authorising officer Department -_|- issue | expiry

 

 

 

 

 

 

 

 

 

 

 

 

fae, cena He igrcaccabtemenNss tte RE AN ab

" Qwidr's consent fi appleby ~ lrherntrmation provide n ho advice section atthe end ofthe fxm, a,
9. Complete Table H for applications involving a material change of use; reconfiguration 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, or on an attachment fo this form if applicable.

    

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Date consent

Table H ‘Premises Owner's name/s Details of the premises owned : j *
Owner's. signature’ | was oblained

and postal address (street address or lot on plan description)

1 weer GINS r 757-8 LK ao Lil ;

 

 

 

 

 

 

 

 

 

* Owner's signature cannot be provided on the form if you intend to submit the apptication electronically. Oumer’s consent must be provided to the assessment manager on an
attachment containing appropriate written documentation of the owner’s consent. If the owner is a company, $127 of the Corporations Act 2001 (Cwealth) details how a
company may sign as owner. Templates for the provision of owner's consent are available on the (PA website .

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