08/2087 - Preliminary Building Work Assessable Against the Planning Scheme [As Published] · 172008.2087

   

INTEGRATED PLANNING ACT 1997 Part A, Version 3.1, 3 March 2006

2. Identify if any of the following apply to the premises by completing Tables D, E, of F. (Note: in most instances, the premises will not involve any of ihe
following characteristics, however some applications may involve one or more of these characteristics - complete only d applicable)

Table 0 Complete if the premises are adjacent to or associated with a water body, watercourse or aquifer (eg. river. creek. fate. consi)
Name of water body, watercourse or aquifer {if known)

 

 

 

 

 

1, NoosA WATERS
Table E Complete if the premises are on Strategic Port Land under the Transport Infrastructure Act 1994
Lot on plan description for strategic port fand Port authority for the fot
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Table F Complete if the premises are in tida! water
Name of local government for the fidal area (Hf apoficable) Name of port authority for the tidal area (if appfcable)

 

 

 

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3. indicate the total area of the premises on which the development is proposed: (Note: The tatal area may include fand both above and below water}
Total area of premises (land on which the development is proposed)
6\5|6l|| ele ne (C1 hectares (~ applicable unit)

cee et 7 te

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Existing use of the premises / - . oe
4. Current use/s of the premises: (e.g. vacant tand, house, towmhouses, apartment building, shop, service station, school, sugar cane farming etc.)
Hovse
5. Are there any existing easements on the premises? (e.g. for vehicular access, electricity, overiand flow, water atc.)
[No (21 Yes - Ensure the type. location and dimensions of each easement are included in plans, submitted with the application
Proposal details :
6. Brief description of the proposal: (e.g. 6 unit apartment building, 30 io residential subdivision, a bore, aquaculture etc.)
Foo. DEEKF -
7. Does the proposal include new building work or operational work {inching any services) on the premises?
Oo No ‘Yes - Ensure the nature, location and dimensions of the proposed works are included in plans. submitted with the application

Resource entitlement (if applicable) - further information is provided in the advice section at the end of the form
8. Does the application involve taking or interfering with a State resource and therefore require a resource entitlement? (e.g. the application
oe State land (leased and freehold). declared Fish Habitat areas, taking quarry material, taking or interfering with water under the Water Act 2000, etc.)
N

lo - Goto OF O Yes — Complete Table G — provide details for each evidence required on a separate row, if applicable. Evidence of resource allocation or
entittement must be submitted with the application, You do not need fo answer Q9- go to the next section.

 

Nature of State-owned resource

TableG — |Nature of evidence required
State Govemment Date of | Date of

Allocation/entitlement . gt * naviel
reference number Name of authorising officer Position of authorising officer Department igsue | expiry |

 

 

 

 

 

 

 

 

 

 

 

 

Ciumer’s consent (t appicabla) — futher information is provided in tho ace section atthe and ofthe form i

9. Complete Tabte 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 tand defined under the
Transport Infrastructure Act 1994 - provide detaits for each owner on a separate row, ar on an attachment to this form if applicabte.

 

 

 

 

 

 

 

Table H Premises Owner's name/s Delails of the premises owned , * Date consent
and postal address _ {street address or fot on plan description) ours" sopue was obtained
1. | WR. FRED BRILMAN | 3B MERM AUD RUA fo
of) FOpSAies PLACE Nowe wWATees :
NOS WATERS

 

 

  

 

the form if you intend to submit the application electronically. Own consent must vided to the assessment manager on an
ions Act 2001 (Cwealth) details how a

*

* Owner's signature cannot be provided on
attachment containing appropriate written documentation of the owner's consent Ifthe owner is a company, S17
company may sign as owner. Templates for the provision of owner’s consent are available on the IPA website .

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