09/1511 - Reconfiguration (Realignment of Boundaries) [As Published] · 152009.1511

INTEGRATED PLANNING ACT 1997 Part A, Version 3.1, 3 March 2008

 

   

Common details

NOTE: Answer all questions unless 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 Applicant is the person responsible for making the application and need not be the owner of the land. The Applicant is responsible for ensuring the
information provided on the IDAS Application Form is correct. This information is relied upon by the Assessment Manager and any referral agencies when assessing end
deciding this application. By lodging this application, the Applicant incurs the obligations and responsibilities prescribed yt the IPA. Any development permit or prefiminary
lepproval thal may be issued.as @ consequence of this application will be isSuéd fo the Applicant.)

 

 

 

 

 

Company/organisation name (if applicable) |

 

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

oO Title [iar -| First name Dean ‘WLastname — ‘Frith i

 

 

 

 

 

Postal address Ice Max Watterson, PO Box 639, COOROY Q 4563 |

Contact telephone number [(07) 54426121 : Mobile phone number 0438 195 825 5

Facsimile number (07} 5442 5121 e-mail address [email protected]

 

 

 

 

 

 

 

[Details of thé. premises (i. the and on which the development is propdséd = refer to the advice at the end of the form) > ee ee |
1. identify the premises by completing Table A, or Table B and/or Table C (ensure adequate information is given fo 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.

 

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

 

 

 

 

 

   

 

 

 

 

 

 

 

 

 

 

 

 

 

OR
TableB Street address for the premises (tick applicable box/es below and insert property description in the table. identify each lot in a separate row.)
O (i) Street address / lot on plan for the premises (Appropriate for most applications including building applications); OF
[J Street address fot 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 obtained from title documents, a ‘Rate’ notice, or from the local government}
tit Sect “s _ Street Adress. . = ; = Lot on ae ape ft bésal government afea (eg. Logan,”
No. | ‘No. Street Name and official suri name Post Code tot No,’ Plan Number A Caims) : we
4 210 | Lawnville Road, Black Mountain 4563 21 $P161930 Sunshine Coast
2 212 | Lawnville Road, Black Mountain 4563 22 SP161930 Sunshine Coast
AND/OR .
Table C Coordinates and/or a map of the premises (Appropriate for development in remote areas, over part of a fot, in water (e.g. channel dredging in Moreton |
Bay) etc.) .
. Coordinates _ 7 . . : -
(Note: place each set of coordinates in a separate row} Zone . Local government area
. . . . Reference. Daturn (If applicable)
Easting Northing Latitude _ Longitude . . Lo . an
1 [i oepas4
[7 wesea
[T; Other -

 

 

 

 

 

 

 

 

 

 

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