08/1127 - MCU - Entertaining & Dining Business Type 1 - Food & Beverages [As Published] · 132008.1127

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, fake, canal)

 

Name of water body, watercourse or aquifer (if known)

 

[1

 

Table E Complete if the premises are on Strategic Port Land under the Transport Infrastructure Act 1994

 

Lot on plan description for strategic port fand Port Authority for the lot

 

[1

 

Table F Complete if the premises are in tidal water

 

Name of local government for the tidal area (if applicable) 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

 

69.00 [x]m? [hectares (Tick applicable unit)

 

 

 

 

‘Existing use of the premises —
4. Current use/s of the premises: (e.9. vacant land, house, townhouses, apartment building, shop, service station, school, sugar cane farming etc.)

 

@ [1 [Medical Centre

 

5. Are there any existing easements on the premises? (e.g. for vehicular access, electricity, overland flow, water etc.)?
No [LJ Yes - Ensure the type, location and dimensions of each easement are included in plans, submitted with the application

Proposal details: . :
6. Brief description of the proposal (e.g. 6 unit apartment building, 30 lot residential subdivision, a bore, aquacuture)

 

Restaurant

 

 

 

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

[Resource enttiernent enpicane) -inor intentions poeta adie scion at te endive om soe

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

No -GotoQ9 (J 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 - go to the next section.
‘Owner's consent (ifeppicabie) - futher information is provided inthe advice section atthe end ofthe form —_ a
9. Complete Table H for applications involving a material change of use; reconfiguration of a lot; work on land below high-water mark and

not within a canal as defined under the Coastal Protection and Management Act 1995; or work on rail corridor land 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.

 

 

 

 

Premises Owner's name/s Details of the premises owned : . Date consent
Table H and postal address (street address or lol on plan description) Owners signature" | was obtained
Simon & Susan Bail x as I 6 / og
1 |PO Box 124 Lot 4 on GTP2026
NOOSAVILLE QLD 4566

 

 

 

 

 

 

 

 

 

* Owmer's signature cannot be provided on the form if you intend to submit the application electronically. 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 .