3836IDAS+Consent Form

 

Table C—Additional aspects of the application (If there are additional aspects to the application please list ina
separate table on an extra page and attach to this form.)

 

imi Refer attached schedule LC Not required

 

 

 

2. Is the application for a mobile and. temporary environmentally relevant activity (ERA)?

 

Xx] No—continue to question 3

| Yes—complete Table D and then go to question 6

 

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

 

 

 

3. Location of the premises (Complete Table E and/or Table F as applicable. Identify each lot in a separate row.)

 

 

Table E—street address and lot on plan for the premises or street address and lot on plan for the land adjoining or
adjacent to the premises. (Note: this table is to be used for applications involving taking or interfering with water).
(Attach a separate schedule if there is insufficient space in this table.)

 

Street address and lot on plan (All lots must be listed.)

C Street address and lot on plan for the land adjoining or adjacent to the premises (Appropriate for
development in water but adjoining or adjacent to land, e.g. jetty, pontoon. All lots must be listed)

 

 

 

 

 

 

Street address Lot on plan Local government area
description (e.g. Logan, Cairns)
Lot Unit Street Street name and official Post- Lot no. Plan type
no. no. suburb/ locality name code and plan no.
i) 38 Pavilion Street, Pomona | 4568 4 RP196984 Noosa
ii)
iii)

 

 

 

 

 

 

 

Planning scheme details (If the premises involves multiple zones, clearly identify the relevant zone/s for each lot ina
separate row in the below table. Non-mandatory.)

 

 

 

 

 

 

 

 

 

 

Lot Applicable zone / precinct Applicable local plan / precinct Applicable overlay/s
i)

ii)

iii)

3 {DAS form 1

 

VOrSION 2 ©