REFERENCE DOCUMENTS - RAL25/0004 (As Published)

                                                                                                                         Notice
                                                                                             Environmental Protection Act 1994
                                                                                                                Notifiable Activity
                 This template is for use by land owners, occupiers, auditors or local government authorities when giving written
                 notice to the administering authority that a notifiable activity has been, or is being, carried out on land under
                 section s.320A of the Environmental Protection Act 1994 (the EP Act).
                 Please complete all fields below. You can use this template to provide notification of multiple land parcels and/or
                 multiple instances of a notifiable activity. Where this is the case, please clearly identify which land parcel or
                 notifiable activity the information relates to.

                  GUIDE                                        1. Details of person(s) giving notice
                  Please ensure that all information is
                  current and correct.                         I am the owner of the land
                  In some circumstances the duty to
                  notify about a notifiable activity may       I am the occupier of the land (e.g. tenant)
                  arise for a number of different
                  people.                                      I am a representative of the local government authority for the land
                  In such circumstances a number of
                  persons may comply with their                I am an auditor performing an auditor’s function for the land
                  individual duty to notify by jointly
                  providing this notice.                        A joint notification is being provided by more than 1 person, the details
                                                            of each person are attached.
                                                            FULL NAME                                                        TITLE

                                                            Mr. Larry Sengstock                                              CEO - Acting

                                                            COMPANY/ORGANISATION/LOCAL GOVERNMENT AUTHORITY

                                                            Noosa Shire Council

                                                            POSTAL ADDRESS                                                   POSTCODE

                                                            PO Box 141 Tewantin                                              4565

                                                            PHONE                                    FAX

                                                            07 5329 6500                             NA

                                                            EMAIL

                                                            [email protected]


                  Lot and plan details can be                  2. Details of land subject to the notification
                  obtained from the land title
                  certificate, rates notice or your local
                  government (local council).               STREET ADDRESS
                  If you do not know the lot and plan,
                  please provide sufficient
                                                            62 Lake Macdonald Drive, Cooroy, Qld, 4563
                  information about the land to
                  enable it to be identified.               LOCAL/PROPERTY NAME (IF APPLICABLE)




                 Page 1 of 5 • ESR/2015/1845 • Version 5.00 • Effective: 03 FEB 2020                                      ABN 46 640 294 485




Document Set ID: 23717062
Version: 0, Version Date: 01/01/1900