10/0632 - Prescribed Tidal Works - Pontoon - Gympie Tc [As Published] · 142010.632

 

 

 

 

Lot on plan description for strategic port land

Port authority for the lot

 

 

 

 

 

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

   

Port authority for the tidal area (if applicable)

 

SUNSHINE Corks T COUNG! EX

 

t10G L oOCABAR

 

 

 

 

 

 

 

i ire caants

| (amaeue

 

eel ag
he re'any. ex jexisting « easements, on: on theipremises: (CBr

a ae

 

mm

 

aa
Thor’ ‘Vehiculars "access, Falect

 

 
  

   

Overland: flow,water

    

 

 
 

[7 No [| Yes—ensure the type, location and dimension of each easement is included in the plans submitted

  

 

 

 

 

 

 

 

   
   
 

ay ema EEO

applicable to't

 

 

No—go to question 15

O

Yes

 

   

 

Yes—complete table K and submit with this application the yellow local government/private certifier’s copy of the

receipted QLeave form

(Sadr arn cx

tevybeen pa paid

 

 

 

 

Table K

Amount paid

Date paid
E, Lor P)

QLeave Project Number (6 digit number starting with A, B,

 

 

 

 

 

  

 

 

 

Uperseded planning.

 

Sete eager ae ante

  
     

ibis app appli

 

 

Yes—please provide details below

 

*

 

 

Name of local government

Date of written notice given
by local government

Reference number of written notice given
by local government (if applicable)

 

 

 

 

 

 

 

 

Application details~{DAS form 1
Version 1.0 18 December 2009

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