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                 INTEGRATED PLANNING ACT 1997                                                                                                Part A, Version 2.4, 29 May 2006
                      )    LK                  Form       1   Development Application                                                                         eS

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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
                          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 fand                         1.   Street address: {nctudinghouse number, street name, suburb/ocality name & postcode) (if applicable)
                  All land the subject of the application, must be      ;                  TS                                                                      ,
                  dented, However, 2 descr  fhe and fo                        Noosa                Parade                      _,Necs4         HEADS                USC7
                     ttenmntaly Recent actey (ER              2.   Name of water body or watercourse, within which the development is proposed: (if appficable)
                  wiamemencene,                          | [NCoaA                          Cive@,
                  development is proposed within a water body or                 =    —          V    ie                        -
       @         watecourse,                                  3.   Lot on plan.déscription (eg. Lot 123 on RP 4567)! GPS coordinates:                                     .
.                 Advice for completing Q3 - Most fand can be                    7                                                 7
                  Wentfedby ataton dan desta, Tose deta
                     be obtained from title documents or through the               ——
                 local government. "      mens ores           4.   The above description is for: (tick applicable box)
                  However, ithe land on wich the developments     CJ (i).   the land on which the development is proposed; or
                   re dorebpmene proposed ina waterbody cr fe           ii) the land adjoining the water body or watercourse, within which the development is
                 watercourse) provide =  te                                 proposed; or
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                   8 shina! ahovent aa     me                      ["] (iii) the water body or watercourse.
                   erohievadnentlord fen Meeten Bay.          |.   Shop/tenancy number.             6,   Storey / level:              7,   Total area of land: (m? or ha):
                     GPS coordinates where there Is
                  a a
                  development is within a water body or watercourse.                                                                                                            .
                                        -      i  i          |                               .    .   ‘         .  .       ’                  ‘              5    .           .
                                  aR tral govenment area.     8.   Local govemmment area in which the land is situated: (eg. Esk, Hervey Bay, Woocoo etc) (if applicable)
                   rivronminrnwaemamneraone | (vaosA. COUNC{e.                                                                                                        id
                  focal government's area unless provided for under the NO U >       -  C OM           4       -                                                           ,      .
                   Local Gavemment Act 1993.              +   |9.  Port authority for the strategic port land or strategic port land tidal area on which the
                  I                tae aerebae von ae i stoi       development is proposed: (eg. Port of Brisbane, Port of Townsville) {if applicable)
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                   priitidomaFermmceserarwadtt|                [Mey
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                   Proposal details                           10.  Existing use of the land: (eg. vacant, single house, shop etc.)
                   sonore
       @           provided in an attachment to the application.       1YXIS-OC
                                                              11.  Proposed use of the land: (eg. 6 unit apartment buitding, 30 lot residential subdivision, ERA for aquaculture in
                                                                   ponds with a total area of 7 ha for which wastes are released into waters efc).
                                                                     WHEE                     JETS.
                   Other applicable parts of Form 1           12.  Other parts of Form 1 completed as part of this application: (eg. Part D, Part /, etc)
                   camer ermettt, | (BP
                   completed parts of Form 1. For Information about    ee,
                 when a part of Form 1 may apply refer to Guide 4,     c/
                  Applicant details                           13.  Applicant's name:                                 15.  Contact person:                                       :
                   cpomnesmfeteomadteans                  > |       Ka     Noosa    Jetty Kurita               _|                                o
                   When staning and lodging this application ==. (14. Contact number:                                16.  Facsimile number/e-mail address:
                   information provided is correct. The assessment                     \                                                           aC)
                  manager, any referral agency & the Chief Executive                                                                                     -
                   {where epplicabie) will rely on this information when | 17. Postal address:                                            “ma | oa
                   romaine                                              20    Rex 294 Meas)                                               Wa
                   Hove   apfiart isa compen contact person        | FO. Be                              Voosuville “ \we tel >» |
                   must be shown.                             18.  Signature:                                                  Cv pate: AL                   XY ;
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