Development Application - Part 1 of 2 - Covering Letter, IDAS Forms 1, 6 & 23 - OPW13/0069

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         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

                                                                                         D     GDA94

                                                                                         D     WGS84

                                                                                         D     other


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


               3,........

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




    I     Hou_




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

        D       No          D     Yes-provide details below

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




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

        D      No


        ~ Yes-complete either Table G, Table H or Tab!e I as applicable

        Table G

        Name of o",!ner/s of the land


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

        Signature of owher/s of the land


        Date


        Table H

        Name of owner/s of the land


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


I       Table I

        Name of owner/s of the land


    4                                                                                                  IDAS form 1-Application details
                                                                                                        Version 2.017 December 2012