3836IDAS+Consent Form

 

Table F—premises coordinates (Appropriate for development in remote areas, over part of a lot or in water not
adjoining or adjacent to land e.g. channel dredging in Moreton Bay.) (Attach a separate schedule if there is insufficient
space in this table.)

 

 

 

 

 

Coordinates Zone Datum Local government
(Note: place each set of coordinates in a separate row.) reference area (if applicable)
Easting Northing Latitude Longitude

[1 Gpag4

L] wese4

CE] other

 

 

 

 

 

 

 

 

4. Total area of the premises on which the development is proposed (indicate square metres)

 

 

1,876m?

 

5. Current use/s of the premises (e.g. vacant land, house, apartment building, cane farm etc.)

 

 

House

 

 

6. Are there any current approvals (e.g. a preliminary approval) associated with this application? (Non-
mandatory requirement.) : : :

 

No [] Yes—provide details below

 

List of approval reference/s Date approved (dd/mm/yy) Date approval lapses (dd/mm/yy)

 

 

 

 

 

 

7. 1s owner’s consent required for this application? (Refer to notes at the end of this form for more information.)

[-] No

Yes—complete either Table G, Table H or Table | as applicable

 

 

Table G

 

Name of owner/s of the land

 

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

 

Signature of owner/s of the land

 

Date

 

 

Table H

 

 

Name of owner/s of the land Alisa Christine Wythes

 

The owner's written consent is attached or will be provided separately to the assessment manager

 

 

Table |

 

Name of owner/s of the land

 

 

 

 

4 IDAS form