Development Application for permit to damage vegetation - OPW13/0609

                 DO

 1. What is the nature of     development proposed? (tick all applicable box/es)


 D material change of         use of     premises

 D building work
        operational work

 D reconfiguring lot     a




12.What type approval being sought?
                 of            is



  @ development permit D preliminary approval                            D       both-provide details below




 3. Is the application for a mobile and temporary environmentally relevant activity (ERA)?


 @NO
 D Yes-complete table A and then go to question 5

 Table A-name of each local government area in which the mobile and temporary ERA is proposed to operate




 4. Location of the premises (complete table B and/or table C as applicable. Identify each lot in a separate row)



Table B-street address/lot for the premises or street address/lot on plan for the land adjoining or adjacent to the
 premises
        0,treet address/lot         on the   plan

        D street address/lot        on   plan for the land adjoining or adjacent to the premises (appropriate for development in
            water e.g. jetty, pontoon)


 Street address                                                        Lot on plan description      Local government area
                                                                                                    (e.g. Logan, Cairns)
 Unit     Street      Street name and official suburb/        Post-    Lot no.      Plan type

 no.       no.        locality name                          code                  and plan no.


                       NOOSI9            11’ft2.r;                                 tr1P ta:r7
           tiS-
                       /VO S.4
                                      UBA.DS                 4-~67




                 2                                                                              Application detai/s-IDAS form 1
                                                                                                  Version 1.0 18 December 2009