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10/0632 - Prescribed Tidal Works - Pontoon - Gympie Tc [As Published] · 142010.632
dredging in Moreton Bay)
iTable C—premises coordinates (appropriate for development in remote areas, over part of a lot or in water e.g. channel
Coordinates Zone Datum Local government
(note: place each set of coordinates in a separate row) reference area (if applicable)
Easting Northing Latitude Longitude
SIG 22h L_] space
Els} o3-+ [] wese,
| other
Fiat HR TAN emer cam eh 3
he.premise apartment*building?
tees oe ee eid a ip
ef PoATOON AT F
PROUIS con
ND OF Ex. ST Hw
re,information) Bite
me Yes—complete either table D, table E or table F as applicable
APrRouAW Oy DERM Sea
AtTTKCHED
Table D
Name of owner/s of the land
1/We, the above-mentioned owner/s of the land, consent to the ma
king of this application.
Signature of owner/s of the land
‘
Date
Application details—IDAS form 1
Version 1.0 18 December 2009
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