08/1928 - Preliminary Building Approval [As Published] · 172008.1928

INTEGRATED PLANNING ACT 1997 PartA, Version 3.1, 3 March 2008

2. Identify if any of the following apply to the premises by completing Tables D, E, or F. (Note: in most instances, the premises will not involve any of he
following characteristics, however some applicalions may involve one of more of these characteristics ~ complete only if applicable)

Table D Complete if the premises are adjacent to or associated with a water body, watercourse oF aquifer (e.g. ver, creek, take, canal)

{ Name of water body, watercourse or aquifer (if known) |

1. | i

Table £ Complete if the premises are on Strategic Port Land under the Transport Infrastructure Act 1994
Port authority for the lot |
f

Lot on plan description for strategic part land
Table F Complete if the premises are in tidal water
fn

3, Indicate the total area of the premises on which jhe development is proposed: (Note: The folal area may Include fand both above and below water)
Total area of premises (land an which jhe development Is proposed) _|

xX q | ~ | |. | wie Q hectares ( appitcuble wy |-

Existing use of the premises
4, .. Current use/s of the premises: (9.9. vacant land, house, fownhouses, apartment building, shop, service stalion, school, sugar cane farming etc.)

 

 

 

 

 

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 
 
  

   
 
  
 

   
   

en

ASTBo ING) é.

  

5. Are shére any existing easements ort the premises? (0.9. for vehleviar so i ‘overl
No . QO Yes - Ensiva ths typo, teceon aad dinensions of euch Baseradt Ue Juchided in pans Sabtedtied willl Ge 2RRiC

Proposal details

8. Brief description of the proposal: (e.g. 6 unit apartment building, 90 fot residential subdivision, a bore, aquaculture atc.)

x CRCCT | _ ce Dw
7. Does the proposal includé new building work or eperational work reg services) on the premises?
oO No Yes - Ensice tie ature, focalion att dimensions Of the proposed works We atcludedd ot paris, Sediranltett avila appa sented

 

Resotirce entitlement (ifappicable) - further infornauion is provided in the advice section at the ead of the fora

8. DoesAne application involve taking or interfering with a State resource and therefore require a resource entitlement? (e.g. the application

invoyfes State land (leased and freehold), declared Fish Habitat areas, taking quarry material, taking of interfering with water under the Water Act 2000, atc.)
No = Get Oy oO Yes - Compivte Table G + provide details far wetcht avitenice required sl el Separate 10 af appheabia & ‘
enhtonent aust be subvited wilt the applicanon. You ¢o Or need tu answer OY = Yu 10 [Ae Lie

 
   

 

 

 

Nature of State-owned resource |

Table {Nature of evidence required
Allocation/entitlement sal : wai Stata Gavernment | Dale of | Date of
F Name of authorising officer Positlon of authorising officer Department issue _| expiry

feference number
Owner's consent iif applicable) - further information is provided jn the advice section at ihe end of the form
9. Complete Table H for applications involving a material change of use; reconfiguration of a lot; work on land below high-water mark and not
within a canal as defined under the Coastal Protection and Management Act 1995, or work on rail corridor land defined under the
Tr ansport Infrastructure Act 1994 - provale cleteuls for wach ownel OF trsepuinty fore OF unt at attacherene to this ton t appacatts,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date consent

Table H Premises Owner's name/s Details of the premises owned , +
Owner's signature was obtained

and postal address (streot address of lot on plan description)
1 | SIE ORFECSO LEATHER woof

[ERE ie Le Siem. Lobe. Wolell

eee

* Owner's signature cannot be provided on the form if you Intend to submit the application electronically. Owner's consent must be provided to the assessment manager on an
attachment contalning appropriate written documentation of the owner's consent. ifthe owner Is a company, $127 of the Corporations Act 2001 {Cweallh) details haw a
company may sign as owner. Tamplates for the provision of owner's consent are avaliable on the JPA website - .

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