img-630164925-0001

 

Oo Impact assessment O Code assessment

 

 

Table C—Additional aspects of the application (If there are additional aspects to the application please list in a
separate table on an extra page and attach to this form.)

 

| Refer attached schedule C] Not required

 

2. Location of the premises (Complete Table D and/or Table E as applicable. Identify each lot in a separate row.)

 

 

Table D—Street address and lot on plan for the premises or street address and lot on plan for the land adjoining or
adjacent to the premises (Note: this table is to be used for applications involving taking or interfering with water).
(Attach a separate schedule if there is insufficient space in this table.)

 

| Street address and lot on plan {All lots must be listed.)

| Street address and lot on plan for the land adjoining or adjacent to the premises (Appropriate for
development in water but adjoining or adjacent to land, e.g. jetty, pontoon. All lots must be listed.)

 

 

 

 

 

Street address Lot on plan Local government area
description (e.g. Logan, Cairns)
Lot Unit Street Street name and official Post- Lot no. Plan type
no. no. —_—|_ suburb/ locality name code and plan no.
i) School St, Pomona 4568 41 AP19201 Noosa
if)
iti)

 

 

 

 

 

 

 

Planning scheme details (If the premises involves multiple zones, clearly identify the relevant zone/s for each lot in a
separate row in the below table. Non-mandatory)

 

Lot Applicable zone / precinct Applicable local plan / precinct Applicable overlay/s

 

i)
ii)
ili)

 

 

 

 

 

 

 

Table E—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
-26.368062 152.853428 [} Gpag4 | Noosa
[|] wese4
C] other

 

 

 

 

 

 

 

 

3. Total area of the premises on.which the development is. proposed (indicate square metres)

 

 

180m2

 

 

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

 

 

 

Previously disused store for Qld Parks & Wildlife leased to Men’s Shed Pomona, a not-for-profit organisation, for use
for Men’s Shed activities.

 

 

IDAS form 1-—-Application details
Version 4.1—4 July 2014