DOC190912 · OPW12/0365

OOO

Table i

Table )

 

 

Lot on plan description for strategic port land

Port authority for the lot

 

 

 

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

Port authority for the tidal area (if applicable)

 

 

 

 

 

 

Yes—complete table K and submit with this application the yellow local government/private certifier’s copy of the

receipted QLeave form

Table K

 

Amount paid

Date paid QLeave Project Number (6 digit number starting with A, B,

E, Lor P)

 

 

 

 

 

 

 

C] Yes—please provide details below

 

Name of local government

Date of written notice given
by local government

Reference number of written notice given
by local government (if applicable)

 

 

 

 

 

 

 

Application details—lDAS form 4
Version 1.0 18 December 2009