Development Application for permit to damage vegetation - OPW13/0333

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    Table F-premises coordinates (Appropriate for development in remote areas, over part of a lot or in water not
    adjoining or adjacent to land e.g. channel dredging in Moreton Bay.) (Attach a separate schedule if there is insufficient
    space in this table.)

    Coordinates                                                                                                                                                                          Zone                                      Datum                                                            Local government
    (Note: place each set of coordinates in a separate row.)                                                                                                                             reference                                                                                               area         (if applicable)

    Easting          Northing                                              Latitude                                                  Longitude

                                                                                                                                                                                                                                     D                     GDA94

                                                                                                                                                                                                                                     D                     WGS84

                                                                                                                                                                                                                                     D                     other


    4. Total are.a of the prerni.$es,on whi b
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    5. Current use/s of                   the premise~ (e.g. vCl_cant land, h’o tJpe aP ctm Dt,b.uildl~g! c~ne far’m"e,tc.)’,                                       ,




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    6. Are there any current approv.als (e.g’.a’prelimin’ary approval)’associated with this                                                                                                                                                                                    pp!icati9n? (Non-                                    ,


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    o        No          D                Yes-provide details below

    List of approval reference/s                                                                                                    Date approved (dd/mm/yy)                                                                                               Date approval lapses (dd/mm/yy)




    7. ts   own’er’s,’~Qns~~n;(,r.,q~i~~d t ~t~i::~;P ~atii>nl( ~ r::to, ~9t~SJ~tJhl;’~h.d. f~~is f :~Q1J9r.~ rs, i.Df J~. ti ,n.)
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,.J2J/ No
    D       Yes-complete either Table G, Table H or Table I as applicable

    Table G

    Name of owner/s of the land


    I/We, the above-mentioned owner/s of the land, consent to the making of this application.

    Signature of owner/s of the land


    Date


    Table H

    Name of owner/s of the land


    D The owner’s written consent is attached or will be provided separately to the assessment manager


I
    Table I

    Name of owner/s of the land


                                                                                                                                                                                                                                                                               IDAS form 1-Applicatlon detmls
                                                                                                                                                                                                                                                                                    Version 2.0 17 Deceml)er 2012