Development Application part 1 of 2 Idas forms 1 & 6 PBA11/0061

qqq
8. Is owner's consent required for this application? (refer to notes at the end of this form for more information)


q No
® Yes - complete either table D, table E or table F as applicable


Table D (note: do not complete this table if lodging the application on-line using Smart eDA)


Name of owner/s of the land        Jean Luc Chaudet

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                               3rd August 2011


Table E


Name of owner/s of the land

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

Table F


Name of owner/s of the land
                                   F
  By making this application, I, the applicant, declare that the owner has given written consent to the making of
q the application.


9. Does the application involve a state resource? (e.g. the application involves state land, or taking quarry
materials. Refer to the notes at the end of this form for more information)


® No                             q Yes - complete table G


10. Identify if any of the following apply to the premises (tick applicable box/es)

        adjacent to a water body, watercourse or aquifer (e.g creek, river, lake, canal) - complete table H
        on strategic port land under the Transport Infrastructure Act 1994 - complete table I
        in a tidal water area - complete table J

11. Are there any existing easements on the premises? (e.g. for vehicular access, electricity, overland flow,
    water, etc.)

   No     q Yes - ensure the type, location and dimension of each easement is included in the plans submitted




                                                                                             gyp!,^,!        - IDAS form 1
                                                                                             Version 1.0 18 December 2009