07/1728 - Change to Development Approval - Boundary Setback [As Published] · 132007.1728.02

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

Form 1 Development Application

 

Part A

Common details

NOTE: Answer all questions unless directed to go to a particular question. Refer to the end of the form for advice on how to complete this form.

Applicant details (The Applicant is the person responsible far making the application and need not be the owner of the land. The Applicant is responsible for ensuring the
information provided on the IDAS Application Form is correct. This information is relied upon by the Assessment Manager and any referral agencies when assessing and
deciding this application. By lodging this application, the Applicant incurs the obfigations and responsibilities prescribed by the IPA. Any development permit or preliminary
approval that may be issued as a consequence of this application will be issued to the Applicant.)

Company or organisation name (itappicabie) GINA CELT) FI SIFI0, fp GL OLPf LIY- LI.

Individual applicanContact person (if there is more than one applicant, provide additional applicant details on an attachment to this form}
. " -} Last c
Title] 77,22 , |First name CHPWE name | 227 GO tfp n/

Postaladcress | 72 BOX /4S 2 VOLEAV/ILLE QC PLO SEL
_ Contact telephone number OL “LG O3F SE : Mobile phone number

Facsimile number SAG Pk Ss email address shace A geotton babel [a
LLee

COM.
Details of the premises (ic. the land on which the development is proposed - refer to the advice al the end of the form}

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1. _ Identify the premises by completing Table A, or Table’B andfor Table C (ensure adequate information is given to identify the premises)
Table A _ If the application is for a mobile and temporary Environmentally Relevant Activity (ERA), complete Table A only. Then goto 02.
Name of each local government area in which the mobile and temporary ERA is proposed to operate .

*y,
1. .

 

 

 

 

 

 

OR

Table B Street address for the premises ( applicable box/es below and insert property description in the table. identify each lot in a separate row.)
(i) XM Street address / lot on plan for the premises (appropriaie for most applicetions including building applications): or rf

(ii) [1 Street address ot on plan for the land adjoining or adjacent to the premises (Appropriate for development in water 6.9. jetty. pontoon
etc) (Note: Lot on pian details may be obtained from title documents. a ‘Rate’ notice, or from the local government.)

 

 

 

 

 

 

 

 

 

 

 

 

 

Street address Lot on plan description Local government area fo.
Unit Street A - Post Plan type and Logan, Cairns)
No. No. Street Name and official suburb/ocality name Code Lot No. Plan Number
Wl | D2 | Tt peop 708, \b8CC\8/7| BP 02577, NO08 9
WIOEA VSL LE .
AND/OR
Table C Coordinates and/or a map of the premises (Appropriate for development in remote avees, over part of a lot, in water (e.g. channel dredging in Moreton Bay) etc.)
Coordinates
(Note: plce each set of coordinates in a separate row) Zone Datum Local goverment area
- ~ = - Reference (if applicable)
Easting Northing Latitude Longitude
1. [1 coae4 (] wess4
C) Other

 

 

 

 

 

 

 

 

 

 

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