Application for permit to damage vegetation - 291 Gympie Terrace Nossaville

 

 

 

 

 

 

 

 

Table I Lot on plan description for strategic port land Port authority for the lot

 

 

 

Table J

Name of local government for the tidal area (if applicable) Port authority for the tidal

area (ifa

pplicable)

 

 

 

 

 

 

 

  

5S ae ae Se ce

ch

[A No L] Yes—ensure the nature, locatio

 

Yes—complete table K and submit with this application the yellow local government/ private cert
receipted QLeave form

 

ifier’s copy of the

 

Table K Amount paid Date paid QLeave Project Number (6 digit numbed

E, Lor P)

r starting with A, B,

 

 

 

 

 

 

 

 

[| Yes—please provide details below

 

 

 

 

 

 

 

 

Name of local government Date of written notice given | Reference number of written notice given
by local government by local government (if applicable)
g Application details~IDAS form 1

Version 1.0 18 O

lecembet 2009