09/1065 - Prescribed Tidal Works - Transport Type 5 - Domestic Marine [As Published] · 142009.1065

INTEGRATED PLANNING ACT 1997

Part A, Version 3.1, 3 March 2008

idas)

 

 

Common details

OTE: Answer all questions untess directed to go to a particular question. Refer to the end of the form for advice on how to complete this form.

 

“Applicant details (The Appicant is the person responsibie for making the application and need not be the owner of the land: The Applicant is responsible for ensuring the
Tinformation provided on the IDAS Application “orm is correct. This information is relied upon by the Assessment Manager and any referral agencies when assessing and
Tdeciding this apptication. By lodging this application, the Applicant incurs the ob&gations and responsibéties prescribed by the IPA, Any development permit or prefminary
‘approval that may be issued as a conscquence of this application wil be issued to the Applicant)

 

 

Company/organisation name (if applicable) |

 

Individual applicant/Contact person (If there is more than one applicant, provide additional applicant details on an attachment to this form)

Postal address [13 Dolphin Crescent Noosaville QLD 4566

 

Title

Lastname Guthrie

 

 

 

 

 

 

 

 

Contact telephone number {07 5473 0912 Mobile phone number 0414990708
Facsimile number | email address [email protected]

 

 

 

Title

First name

 

 

Last name

uthrie

 

Postal address

 

[13 Dolphin Crescent Noosaville QLD 4566

 

 

 

 

 

 

 

 

Contact telephone number 07 5473 0912 Mobile phone number 0413 920 443
Facsimile number [de mait address [email protected]
Details of the premises (ie. the tand on which the development is proposed - refer to the advice at the ond of the form) |

 

1. Identify the premises by completing Table A, or Table B and/or Table C (ensure adequate information is given to identify the premises)
Table A If the application is for a mobile and temporary Environmentally Relevant Activity (ERA), complete Table A only. Then go to Q2.

 

[ Name of each local government area in which the mobile and temporary ERA is proposed to operate

[1
OR
Table B Street address for the premises (tick applicable box/es below and insert property description in the table. Identify each lot in a separate row.)

 

 

 

 

(i) q Street address / tot on plan for the premises (Appropriate for most applications including building applications); Of

(ii) [-] Street address /lot on plan for the land adjoining or adjacent to the premises (Appropriate for development in water e.g. jetty,
pontoon etc) (Note: Loton plan details may be oblained from title documents, a ‘Rate’ notice, or from the tocal government.)

 

 

 

unit | Steet Ses eaton a Local government area (e.g. Logan,
No. | No. Street Name and official suburbfocality name | Post Code | Lot No. Plan Number Caims)
1 13 Dolphin Crescent Noosaville 4566 4 N10573 ‘Sunshine Coast