06/1266 - Op Works Transport Type 5 Domestic Marine [As Published] · 142006.1266

INTEGRATED PLANNING ACT 1997

 

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Part A, Version 2.2, 25 Juty 2005

Development Applicatio A
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RECEIVED Ye

 

 

 

The completion of all appticable questions on Part A is mandatory far all applications. Part A must be accompanied by the completed IDAS Assessment Checklist if
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 compieting the following details, refer to Guide 1.

Description. of land

\ Allland the subject of the application, must be
identified. However, a description of the fand is not
required in relation to a mobile or temporary

1.

 

Street address: fncludinghouse number, street name, suburbViocality name & postcode) {if applicable)

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Environmentally Relevant Acthity (ERA). 2. Name of water body or watercourse, within which the development is proposed: (if applicable)
Advice for completing Q2 - 02 applies if
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
ied by alton plan despa. These deals [fo4 (25 RP ¥g@ziso |
tit ’
een Nedocunentsortioushite 14 The above description is for: (tick applicable box}
However, if the land on which the development is (1 @ the land on which the development is proposed; or
have a lot on plan description (i.e.
Me coateonette prscced navater baton fe oO (ii) the land adjoining the water body or watercourse, within which the development is
watercourse) provide - proposed; or
{i} the lot on plan description for the re
; axingecent de C1 (ili) the water body or watercourse.
® Srna and (eg. in Moreton Bay). §. Shop / tenancy number: 6. Storey / level: 7. Total area of land: (m? of ha):
Advice for completing Q7 - Q7 does not apply if the — oa
development is within a water body or watercourse. | OD fi € | | & 0 o |
Advice for completing QB - 08 applies if aaa ii ‘ te cj . cs .,
development is within 9 local government area. 8. Local government area in which the land is situated: (eg. Esk, Hervey Bay, Woocoo ele.) (it applicable)
Note: Areas below high water mark are not within a A
focal government's area unless provided for under the | Mi Q 9 3 f ~ ~ ;
Local Goverment Act 1993. _ 9. Port authority for the strategic port land or strategic port land tidal area on which the
aes for completing 2e nat Pra a skategic development is proposed (eg. Port of Brisbane, Port of Townsville) (if applicable)
porttand fidal area, For more details refer to Guide 14
Proposal details 10. Existing use of the land: (eg. vacant, single house, shop etc}
if there is insufficient room available, details may be
provided in an attachment to the application. [ Si no Io Storey house . |
+14. Proposed’ usé-é the land: feg. 6 unit 2partment building, 30 fot residential subdivision, ERA for aquacutture in
ponds 1 wilh a tolal area of 7 ha for which-wastes are released into waters etc). . .

ee | Kos idlance. |
Other applicable parts of Form 4 12. Other parts of Form 1 completed.as part of this application: (eg. Part D, Part J, etc) .
Part A'must giwayg be accompanied by other
completed parts of Form 1: For information about |
when apart of Form 1 may apply reter to Guide 1. . ;
Applicant details 13. Wecc name:  45.. Contact persgn:
Clearly identify who is making the appfcation. The
spplicant need no! be te owmer of fe lad. vicoEeR WChuis_licinideetrese |
When sidning and lodging this application 14, cent number. 16. Facsimile number/e-mail addie:
‘The applicant is resporisiblé for ensuring the
intonation: provided is correct: The assessment o7 (or) SE2¢9712 | ?

i ‘ay referral agency & the Chief Executive
{ietione Pes rely. oh this information when | 17. (Dur 29% 02 ___ address:
assesain and deciding the applic
is dbacantis come | Ue Ine Ria Aap avAy  Mwos4 wares ERG)
mmustbg shown, = 18, Signature. , 49. Date

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