OPW13/0859 Application for permit to damage vegetation 8 Bunya Lane Black Mountain

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

                   o Refer attached schedule                               0Not required


          2. 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.)
                  0 Street address and lot on plan (All lots must be listed.)
                  0 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
                                      ~                  vN’fA- UrNIZ f6~AU(.                                        Lot on plan                       Local government area

                                                                                           M vr<lh’"                 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.
                                                                                    . A.~/~
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           i)                          ~                 i     ulJ /t L.we tr(1">(}jJ(A              ~~lf-Sb~/(3’~P                   .



           ii)                                                                                                  J     1.’)t",>-’f
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          iii)
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           Planning scheme details (If the premises involves multiple zones, clearly identify the relevant zone/s for each lot in a
           separate row in the below table. Non-mandatory.)
           Lot        Applicable zone/precinct                                           Applicable local plan/precinct                     Applicable overlay/s

           i)

           ii)

           iii)

           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

                                                                                                                                        0 GDA94
                                                                                                                                        0 WGS84
                                                                                                                                        0 other

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


         I 3"          rees             /fY’I Z
           4. Current use/s of the premises (e.g. vacant land, house, apartment building, cane farm etc.)



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                                                                                                                                                   Version 2.031 M8/"cfl2013



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