Development Application for permit to damage vegetation - 15 Blackbean Court Black Mountain · OPW12/0394

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       1;,Wh t is the nature -of develo’pm!nf pr pos d?(tick ll applkable t5 x! s)            .’ ’;,,:, ’.          .;                                                                                                                                            .
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                                material change of use of premises
       D
       D                        building work

                                operational work

       D                         reconfiguring a lot

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




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        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




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

                                ~street address/lot                                                                  on the       plan

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


            Street address                                                                                                                                                                                      Lot on plan description                                                               Local government area
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            Unit                                Street                                 Street name and official suburb/                                                          Post-                          Lot no.                                Plan type

               no.                                 no.                                 locality name                                                                             code                                                                  and plan no.


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                                                                         2                                                                                                                                                                                                               Application details-IDAS form 1
                                                                                                                                                                                                                                                                                               Version 1.0 18 December 2009