001511C5.001

,   ag      *                                                               .                                              Par A, Vittsion 2 4, 95 May AE
        f° * INTEGRATED PLANNING ACT 1907                 oo,                      .           STE TE Te aerate etter        ST   Se RP      AS Se
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                         ARUN OE                 nce rete 9 re ee vy WO point           Bee     ra ee                         a he picted DAS Assessmont Chechdistit
                    Tie complgtioa of all 2ncticabie questions on Parta is Mandatory for, 30 applications, Pant A mast de zecompentad by the corn
                       requied ane by ane (1) O¢ mora other completed ports of the Sort a3 reayized. Fos move information 99 the paris tthe For refer 0 seine capa He
                  Any informe ion reaizested in the idea ricy io provitied in an anachment to'fhe anolcatinn, For further inforiaaiiin about compkting ihe following details, refer Guided
               “Deseription of land -                 i     Street address; dacohignuuse iunber, street naina, suhurlvineoaly name & potvoda} (if applicagle)
                 REESE A ements mrs 20               Ts    Creel addhone Inorg        oS           arene
                Altona 2a cublest ¢rlna agploaton, myaids                                                                                              |
             /  BA, nr AUR ul hy etd is no!            IS fe          cant        Steet                                                              ot
             "+ pelted os falaivn byw mabe & tenporiy                ,                           ‘       '           |           fODOSeG: (¥    aplicable
                Povicimentaly Relesam Actely (ERA). = = 12. Name of water body or watsreourse, within which the deve opment is proposed: (¥ anplicabl)
                Siveccpmcal ts proposed stihin a weter body o ("NR yin nap en Oe
                Advi¢a for cemmpictiny a me oly                                                                                                     .
                walucautsa,                 4          3.   _Loton plan description (eg Lot 423 on AP 4567} /.GPS coordinates:
  @                eens     Cee                             |  Lot \2            on    sP L798 792                   |                         _      }     :
  4      + Advice for completing G3 Usst land nan he       ’                    on SPL TOR IG
                Reagoomoeey Seba                     | |        hove descriolon bbe a applcadie box)
   “            However, at i an Mich te develonnnanti |   Rl (i) the land on which the davelooment is proposed: or
                    WeMmea, .         Jf      .    ‘,   .            .      b     naan                :          ;
                 patpssad does aot haze 2 sot an pis Asscriotion fia, my      bases                 sae urate         tyin whieh  ts       ,
                Ibe dtuelpres vorenar ee hodyar             (] (i) the land adjsining the water body or watercourse, within which the development is
     ‘0         watetourtel provide = x.                   .        proposed; or
                (i) the fot on plan caserweans for ing          ws                   ;
                  rly         oc       .                  LT {ity the water bedy or watercourse,
                8 arngadene nd fp       eon By, -    19    Shop / tenaacy number         6 Storey / teval:             7.   Total area Hang! (ani or hay:
                dedcise (oy seunnteting G2 -2? does poe ape ifths                             I                             [T-                       1
               didlos     ia 2 wor Body     ee       I Lo]                                                      |           (Gtk mt                werd
               Gateelore Sailr etd ynerrent avs      la    Local government area in whlch the land is situated: {4-Esi, Heniay Bay, Wooceo eke (f appa)
.                rico for curpploting 8- C8 ep ptuy 2                 .           te ae            le ee ate cde    .                  ate) lif ancticahle
               Hata: £2c0s haw Kien woies mark ate pot wikna | i     NOOSA
               kes sovernments area ines nrovisod far unser fhe | *             siren A                 Ee ee ey 4 wham en
               Loca! Govemmion: Act 1903, *          19.   Port authortty for the strategic porl land or airatagic port land tidal area on which the
               Advices |   jating 09-09 anpigs       t                                  e                $
           .   &eyick far eamplating 9-09 anpias we wsee we phy         A       apri-               5      Tyan euitet 1; bn
           © eels rae ota segs                       i     Cevelopmentis proposed: ep. Prof     bana, Fat of Tounsvle Ut applicasie)
                  tad Sea area, Hatmova delats rater Gelso i                                                                                         |
               pane     a                eau!              [Nia                                                                       wineunons    . |
       :       Proposal datalls             .        110.  Existing use of ihe land: fog. vacant single houss, sta aie)
               Atiard ingufbdontivcm avehada’éctaly uayty 1  VACANT:                                                                               ey
               Povtlag in an stschmuns inthe application, ©} ive Se       Pe           LT                eee                     aera               J
                            ok                       44, Propased use of tha land: (6g. Sunt sparen buioing, 30 tot rasieantia! sunetivision, BRA for agukeunure in
                                                          Dongs with a tobe! area of? ha ior which wastes ar fe00589 tho welers Blo,
                                .                          TRE aR eg
                    |           |                            TIMPE        SD        DOLE.
             "ee Rone acta             sees            tpt               SD PaaS SSR ST                                    et        epee
              ther applicable paris of Form 4       [%    Other parts of Farm 4 corplotag ag part of this application: (eg, Part 0, Pari / ete}
               STA mig shvava ba excompared by ethse tetra ee POA   ee          SN VelWwals “Por                            peeoo
      "       comnplated sats Fars. Fat hemnelon ho |     | PART          Dh " SVR M es                       Check MST                             ‘
             uaban 6 part af Per may apply salar ip Guide 4, |                                                                                                 ‘
                  .         .      TE ee Sa TR. Appian               ane SSS                            terns
              Applicantdatiis                      113, Applicant's name:             Paw             15. Contact parson:
             agpCOMA NBR Cay ba ha GUT cftalgnd,    |     iLalVin      “loddA       45 HOOSK by           cf     Nadine             Gok, :
.      "  *   Clesny entity who is making the applleatinn. The fa                                            =              nD      ee
              pc uel ny seu sia   inant _ 4 nistlea i‘   Coniset number:                              16. Facsimile number/e-mail address:
               he Haale responsible & dagiiang he         :                    Oa ein emne men army        Sy Se Cn) ee]
             inferior prove ik cgrract Ths cxsscsmen} |  [Suse Chae                                          SY    S5 SFar
      .      TATE, NY Ha atcadl aparey b th Coiar Brecutve   a                 =                         L249               IAT                   |
      ’      Fant    ae ato  ee eon hh             197.  Post adda’:
              aveasiag and deciding the apnfcaton,      .             hn                                 ne
             Pho apace. coninsay a conte persén    |    lel WMiairtoe                    W180 lt LAs         Po        oc         168Y¥         m
             “ee                              *     418. Signature:                                                19. Date,        MICO,           Ket,
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