IDSA Form 1 Sept · OPW16/0221

 

Department of Infrastructure, Local Government and Planning

 

 

5. Are there any current approvals (e.g. a preliminary approval) associated with this application? (Non- foi
mandatory requirement)

 

[-] No [-] Yes—provide details below

 

 

 

 

 

 

 

 

 

 

 

List of approval reference/s Date approved (dd/mm/yy) Date approval lapses (dd/mm/yy)
6. Is owner's consent required for this application? (Refer to notes at the end of this form for more information.)
~ No

CJ Yes—complete either Table F, Table G or Table H as applicable

Table F

Name of owner/s of the land ——

——

 

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

 

Signature of owner/s of the land—~ |

 

 

Table G _———

 

Name of owner/s of the land_——~

 

 

im The owner's ‘written consent is attached or will be provided separately to the assessment manager.

 

Table H

 

 

Name of owner/s of thé land

 

[1 eymaking this application, |, the applicant, declare that the owner has given written consent to the making of the application.

 

 

 

 

7. 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 Tab!
On strategic port land under the Transport Infrastructure Act 1994—-complete Ta

 
  
  

On Brisbane core port land under the Transport InfrastructureAct 1994 (No table requires completion.)

C
LJ
Ll In a tidal water area—complete Table K
O
LJ
O

On airport land under the Airport Assets are Disposal) Act 2008 (no table requires completion)

Listed on either the Contaminated Land Register (CLR) or the Environmental Management Register (EMR) under
the Environmental Protection Act 1994-(fio table requires completion)

 

Table |

 

Name of water body, wateredurse or aquifer

 

 

y

 

 

 

Table J

 

 

 

IDAS form 1-——Appitcation details
Version 4.2--3 August 2015