09/0463 - MCU - Detached House [As Published] · 132009.463

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INTEGRATED PLANNING ACT 1997
Table D Complete if the premises are adjacent to or associated with a water body, watercourse or aquifer (e.g. river, creek, lake, canal)

Part A, Version 3.1, 3 March 2008

 

 

 

[1

 

Table E Complete if the premises are on Strategic Port Land under the Transport Infrastructure Act 1994

 

 

 

{1

 

Table F Complete if the premises are in tidal water

 

 

 

 

[1

 

 

 

 

 

1,253.00

 

 

fk] m? (Jhectares ——_(Tiok applicable unity

 

 

 

 

4, Current use/s

of the premises: (e.g. vacant land, house, townhouses, apartment buikfing, shop, service station, school, sugar cane farming etc.)

 

[1 [VACANT LAND

5. Are there any existing easements on the premises? (e.g. for vehicular access, electricity, overland flow, water etc.)?

&® No oO Yes - Ensure the type, focation and dimensions of each easement ere inckded in plans, submitted with the application

 

6. Brief description of the proposal (e.g. 6 unit apartment building, 30 fot residential subdivision, a bore, aquaculture)

 

2 STOREY RESIDENCE

 

 

 

7, Does the poposal include new buildings or operational work (including any services) on the premises?
0 No &) Yes - Ensure the nature, location and dimensions of the proposed works are included in plans, submitted with the application

 

8. Does the application involve taking or interfering with a State resource and therefore require a resource entitlement? (e.g. the application
involves State land (leased and freehoid), declared Fish Habitat areas, taking quany material, taking or interfering with water under the Water Act 2000, etc.)

BX] No -Go10.a9

C Yes - Complete Table G ~ provide details for each evidence required on a separate row. if applicable. Evidence of resource

allocation or entitlement must be submitted with the application. You do not need to answer Q9 - ga to the next section.

 

9. Complete Table H for applications Involving a material change of use; reconfiguration of a lot; work on land below high-water mark and
not within a canal as defined under the Coastal Protection and Management Act 1995; or work on rail corridor land defined under the
Transport Infrastructure Act 1994 - provide delaits for each owner on a separate row, or on an attachment to this form if applicable.

 

 

Table H

 

 

 

   

Reetr STAKE

 

 

 

 

7 a CL ORE
"EA fy ON MOO WA

LOT TSS AJgasA SPeiw6s

 

 

 

 

4867

 

* Owner's signature cannot de provided on the form if you Intend to submit the appfication electronically. Owner's consent must be provided to the assessment manager on an
attachment containing appropriate written documentation of the owner's consent. If the owner is a company, $127 of the Corporations Act 2001 (Cweaith) details how a
company may sign as owner. Templates for the provision of owner's consent are available on the [PA website .

 

 

 

Tablet

 

 

 

 

Refer to attached

 

 

 

over the counter

 

DRAWING REGISTER - TRANSMITTAL

 

 

 

 

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