07/0773 - Preliminary building work assessable against planning scheme [As Published] · 172007.773

 
 

Common details

Part A, Version 2.4, 29 May 2006

  

 

The completion of all applicable questions on Part A is mandatory for alt applications, Part A must be accompanied by the complated IDAS Assessment Checklist it
required, and by one (1) or more other compieted parts of the Form as required: For more information on the parts of the Form refer to www.ipa.q'd.gov.au,
Any information requested in the form may be provided in an attachment to the application. For further information-about compteting the follwing details, refer to Guide 1.

Description of land

All tand the subject of the application, must be
identified. However, a description of the land is not
required in relation to a mobile or temporary

1.

Street address: (nciuding house number, street name, suburtYlocality name & postcode) {if applicable}

 

[G6 6iuEbEReY De BLACE mouNTAIN & 4563]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

assessing and deciding the appfcation.
licantis a 8 contact person

 

 

 

 

 

 

Environmentally Relevant Activity (ERA). 2. Name of water body or watercourse, within which the development is proposed: (if applicable)
Advice for completing Q2 - Q2 it
aeons Saeed within eS ay oO ~ ]
watecourse. 3. Lot on plan description (eg. Lot 123 on RP 4567) / GPS coordinates:
for teti - Most land can be z
janie alt npn Gostoten. These cots {Lor 121 ¥ jo1378
Care maed Fon We documents or rowan he | 4 The above description is for: (tek applicable box)
However, ifthe land ion which the development is (i) the land on which the development is proposed; or
agarose taalasee dese wea fe . CA (i) the land adjoining the water body or watercourse, within which the development is
watercourse} provide — roposed; or
{i} the lot ori plan description for the _
edfoining/adjacent tend: or O (iii) the water body or watercourse.
® Srna at ed ea ty Moseton Boy). 5. Shop / tenancy number: 6. Storey / level: 7. Total area of land: (m? or ha):
Ai for completing QT - 7 does. nat opp ite | [ ]
development Is within a water body or watercourse. .
Advleé for comoteting QS - 08 apnfes it 8. Local government area in which the land is situated: (ag. Esk, Hervey Bay, Woocde ett.) (if applicable
development is within a local goverment area. - : (eg. Esk, Hervey Bay, .) (if applicable)
Note: Areas bel water mark with
wonenert te newt carne | LACOOSA |
Local Government Act 1993. 9. Port authority for the strategic port land or strategic port land tidal area on which the
asi fr rns oe cooteic development is proposed: (eg. Port af Brisbane, Port of Townsville) (if applicable)
ort fand tidal area. For more details refer to Guide 11 |
Proposal details 10. Existing use of the land: (eg. vacant, single house, shop etc.)
Uae etent mom mai detasmayte | | HOUSE + SHED + INGOOUNO FOOL J
11. Proposed use of the land: (eg. 6 unit apartment building, 30 lot residential subdivision, ERA for aquaculture in
ponds with a total area of 7 ha for which wastes are released into waters atc).
LSHED |
* Other applicable parts of Form 1 12. Other parts of Form 1 completed as part of this application: (eg. Part D, Part /, etc)
PartA must always be accompanied by other
sonphtod pas orto 1 Foafornason soot L PARTE |
when a part of Form 1 may apply refer to Guide 1.
Applicant details . 13. Applicant's name: 15. Contact person:
" Sokartnadaatetnonedtmms | (LOUSE + JUSTIN CADE | Louise OR TusTny |
‘When signi this appli 14. Contact number: 16. Facsimile number/e-mail address:
The applicant is ible for the 5
itor poe! caret Te assesment LO? S4720966 [Cardew 01D trqoond. com
manager, any referral agency & tha Chief Executive WT
(where applicable) will rely on this information when | 17. Postal address:

 

loo Biueserey De BrackmowTai 2 4se3 |
. Signature:

19. Date:

 

 

4 Carcenw

 

 

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