Development Application Part 1 of 2 - IDAS Forms 1 and 6 - OPW13/0425

        Table F-premises coordinates (Appropriate for development in remote areas, over part of a lot or in water not
        adjoining or adjacent to land e.g. channel dredging in Moreton Bay.)(Attach a separate schedule if there is insufficient
        space in this table.)

        Coordinates                                                       Zone         Datum                Local government
        (Note:place each set of coordinates in a separate row.)           reference                         area   (if applicable)
        Easting       Northing         Latitude          Longitude

                                                                                        0 GDA94
                                                                                        0 WGS84
                                                                                        0 other
        4. Total area of the premises on which the development is proposed Qndicate
                                                                                            square metres)

    646m2

        5. Current use/s of the premises (e.g. vacant land, house, apartment building, cane farm
                                                                                                    etc.)

    House




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

        x     No      D      Yes-provide details below

        List of approval reference/s                    Date approved (ddlmm/yy)              Date approval lapses (dd/mmtyy)




        7. Is owner’s consent required for this application? (Referto notes at the end of this form for more
                                                                                                             information.)

    X        No

        D    Yes-complete either Table G, Table H or Table I as applicable

    Table G


    Name of ownerls of the land


    INVe,the above-mentioned ownerls of the land, consent to the making of this application.

    Signature of ownerls of the land


    Date


    Table H

    Name of ownerls ofthe land
                                            I
    D The owner’s written consent is attached or will be provided separately to the assessment manager

    Table I

I   Name of ownerls of the land


    4
                                                                                                   IDAS form 1-Applicafion details
                                                                                                     Version 2.017 December 2012