08/1426 - Preliminary Building Work Assessable Against the Planning Scheme [As Published] · 172008.1426

INTEGRATED PLANNING ACT 1997 Part A, Version 3.1, 3 March 2008
Table D Complete if the premises are adjacent to or associated with a water body, watercourse or aquifer (e.g. river, creek, lake, canal)
Name of water body, watercourse or aquifer {if known}
fr

Table £ Complete if the premises are on Strategic Port Land under the Transport Infrastructure Act 1994
Lot on plan description for strategic port land Port Authority for the lot
[

Table F Complete if the premises are in tidal water
Name of focal government for the tidal area (if appicable) 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 total area may include land both above and below water)

 

 

 

 

 

 

 

 

 

 

 

 

 

Total area of premises

 

1bg8 {Z]m? [Jhectares (Tick applicable uni)

 

 

 

 

‘Existing use of the premises
4. Current use/s of the premises: (e.g. vacant and, house, townhouses, apartment building, shop, service station, school, sugar cane farming etc.)

 

[4 [Residential units

 

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

M No oO Yes - Ensure the type, location and dimensions of each easement are included in plans, submitted with the application
‘Proposal details _ o :
6. Brief description of the proposal (e.g. 6 unit apartment buikting, 30 ot residential subdivision, a bore, aquaculture)

 

Roof on existing deck ¢ RELOCATION OF Poor FENCE (Pagnac)

 

 

 

7. — Does the poposal include new buildings or operational work {including any services) on the premises?
[No [EX] Yes - Ensure the nature, location and dimensions of the proposed works are included in plans, submitted with the application

Resource entitlement (if epp:ceb's) - further inform:ton is provided in the advice section at the end of the form

8. Does the application involve taking or interfering with a State resource and therefore require a resource entitfement? (eg th the application
involves State land (leased and freehold), declared Fish Habitat areas, taking quany material, taking or interfering with water under the Water Act 2000, etc.)

kl] No - Goto Q9 oO 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 - “9 to the next section.
‘Owner's consent (if 2ppcebe) - further Informe‘on is provided in the edvico section at the end of | the form

9. Complete Table H for applications involving a material change of use; reconfiguration ofa tot; work on land below high-water mark and
not within a canat as defined under the Coastal Protection and Management Act 1995; or work on rail corridor tand defined under the
Transport Infrastructure Act 1994 - provide details for each owner on a separate row, or on an attachment to this form if appicable.

 

Date consent
was obtained

Premises Owner's name/s Details of the premises owned

Table H and postal address (street address or fot on plan description)

Owner's signature*

 

 

 

 

 

 

 

 

 

“Owner's signature cannot be provided on the form if you intend to submit the appfication electronicaity. Owner'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 IPA website .

Attachments and supporting information (Comps's Teb's | - Use  sepsrete row for each type of eftachment or informston, inchxting Inform'on required

‘undar this Party Please ensure aif documentation submitted with this form, inchuding other Parts of Form 1, or owner's consent, etc, are sacurely attached to this Part of the Form. i

 

Description of attachment or information

Title (if applicable) Method of delivery to
Table | . Part C of Form 1, owner's consent, evidence of resource Date
(es aflocationventittement, pres dein reports) (e.g. General Authority, James StreetTraffic Report} assessment manager

1 Part £, Checklist, plans