Development Application IDAS Forms 1 & 6 - OPW12/0468

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         DDD
 Table C-premises coordinates (appropriate for development in remote areas, over part of a lot or in water e.g. channel
 dredging in Moreton Bay)

 Coordinates                                                                                                                                       Zone                               Datum                                Local government
 (note: place each set of coordinates in a separate row)                                                                                           reference                                                               area   (if applicable)

 Easting                        Northing                       latitude                                 longitude



                                                                                                                                                                                       D GDA94
                                                                                                                                                                                       D WGS84
                                                                                                                                                                                       D other


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   [l] No
   D Yes-complete either table D,table E                                                 or table F as              applicable



  Table D

   Name of owner/s of the land


   I/We, the above-mentioned owner/s of the land, consent to the making of this application.                                                                                                                                                                    (




   Signature of owner/s of the land                                                        -




   Date




                                3                                                                                                                                                               Application details-IDAS form 1
                                                                                                                                                                                                     Version 1.018 Oecember 2009