Development Application IDAS Forms 1 & 6 - OPW12/0468

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 o material change of                                                               use of                 premises

 o building work
 ell operational work
 o reconfiguring lot                                                 a




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     [zf                           development permit                                                        o preliminary approval                                                                           D               both-provide details below




’.3. ls.the"’ap li~ ti~;ri                                                         r a      ’m~.b e’~I).d t mporarv’ envl!:onment !ly!elev’~iita iv,ity’(ERJ\)?~~’l~
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     r:z1                   No


     o Yes-complete table A and then go to question 5

     Table A-name of each local government area in which the mobile and temporary ERA is proposed to operate




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     Table B-street address/lot for the premises or street address/lot on plan for the land adjoining or adjacent to the
     premises                                                                                                                             J~

                                              street address/lot on the plan


                        o street address/lot                         plan for the land adjoining or adjacent.to the premises (appropriate for development in
                                                                                                on

                                              water e.g. jetty, pontoon)


     Street address                                                                                                                                                                                      Lot on plan description                                                            Local government area
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     Unit                              Street                    Street name and official suburb/                                                                   Post-                                Lot no.                               Plan type

        no.                             no.                      locality name                                                                                      code                                                                       and plan no.


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                                                             2                                                                                                                                                                                                                      Application details-IDAS form 1
                                                                                                                                                                                                                                                                                          Version 1.0 18 December 2009