0015A4F2.001

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              INTEGRATED PLANNING ACT 1997                        .                   :                                                             Part A, Version 2.4, 29 May 2006
                \y"           \               Form         1  Development Application                                                                                  idas

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                   The completion of all applicable questions on Part A is mandatory for.all applications. Part A must be accompanied by the completed IDAS Assessment Checklist if
                           Pp       all applicable questions            mangatory
                        required, and by one (1) or more other completed parts of the Form as required. For more information on the parts-of the Form refer to www.ipa.qid.gov.au.
                 Any information requested in the form may be provided in an attachment to the application. For further information about completing the following details, refer to Guide 1,
.              Description of land                  ,         1.    Street address: fncludinghouse number, street name, suburb/ocality name & postcode) (if applicable)
               identified. However, a description ofthe land is not   430 Black Mountain Road, Black Mountain Qld 4563
                   ired in relation to a mobile or t  ,                                                          ae       ;                        ‘            «Hanan         .
               Environmentally Relevant Activity (ERA)        2.    Name of water body or watercourse, within which the development is proposed: (if applicable)
               development is proposed within a water body or                       —                                                 -
     ©        _ watecourse.                                   3.    Lot on plan description (eg. Lot 123 on RP 4567) / GPS coordinates:
     :         Advice for completing Q3 - Most land can be                    7
               identified by a lot on plan description. These details Lot 89 on SP158854
                   be obtained from title d ts or through th                                                                                                              :
               a soveravent om tite documents or  hrovgh the  4,    The above description is for: (tick applicable box)
               However, if the land on which the development is     {J (i)  the land on which the development is proposed; or
            -  edlevelopmen’ popoeed inswatertodyor        |   -    (J(ii)   the land adjoining the water body or watercourse, within which the development is
               watercourse) provide —                                         proposed; or
         -      i) th      }       iption for th                         vey gp                                                                   ;
               #   oningtedacentionds or    6                       C1 (iii) the water body or watercourse.
              : “ adoitingfajecent land (en Moreton Bay).     5.    Shop / tenancy number:             6.    Storey/level:                  7.    Total-area of land: (m? or ha):
                i) GPS coordinates where there i:
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               development is within a water body or watercourse.
               Advice for completing Q8 - 08 applies if                                        .     .                  gt      .                                         .
               development is within a local government area, 8.    Local government area in which the land is situated: (eg. Esk, Hervey Bay, Woocoo etc.) (if applicable)
               Note: Areas below high water mark are not within a     Noosa Shire Council                                 :
               focal government's area unless provided for under the                                -                          :            -                                            ‘
               Local Government Act 1993.                     9.    Port authority for the strategic port !and or strategic port land tidal area on which the
               Advice for compteting Q9 - Q9 applies if                            A             .              .                     el Fi     .                               .
               development is on strategic portland or a strategic development is proposed: (eg. Port of Brisbane, Port of Townsville) (if applicable)

               Proposal details                               10.   Existing use of the land: (eg. vacant, single house, shop etc.)
     @         provided in an attachment to the application,          Single Detached Dwelling and Cattle Grazing Land
                                                              11.   Proposed use of the land: (eg. 6 unit apartment building, 30 fot residential subdivision, ERA for aquaculture in
                                                                   ponds with a total area of 7 ha for which wastes are released into waters etc).
                                                                           .         .               :                                                                            $
                                           -                          Cabin Park with Three Cabins
               Other applicable parts of Form 1               112. Other parts of Form 1 completed as part of this application: (eg. Part D, Part I, etc)
               Part A must always be accompanied by other                                                :
               completed parts of Form 1. For information about       Form D & Assessment Checklist
               when a part of Form 1 may apply refer to Guide 1.                                                                           :
               Applicant details                         ’    113. Applicant's name:                                     15.   Contact person:
               Clearly identify who is making the application. The                    i     5
               applicant need not be the owner of the land. .            lela           ss we &                                  Blake Bell          :
               When signing and lodging this application      14.  Contact        numb                                   16.   Facsimite number/e-mail address:
      .        The applicant is responsible for ensuring the     »   Lontact number:
               information provided is correct. The assessment        07) 5441 2                                                 (07) 5441 2601                     ‘
               manager, any referral agency & the Chief Executive .   (  )         188
               (where applicable) will rely on this information when                                                                      -
               assessing and deciding the application.        17.  Postal address:
               tthe applicant ts a company - a contact person         PO Box 246
             ; must ba shown,                                         NAMBOUR QLD 4560
  .                                                           18.  Signature:                                                            19. - Date:
                                                                                                                                              20/06/07              :
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