Development Applicaton for permit to damage vegetation - OW13/0168 · OPW13/0168

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              Table F.,xemises ax:K’d             (Appropriatefor development remote areas, over part of a lot or in water not
              adjoining   or adjacent to land e.9. channel dredging in Moreton Bay.)(AUach a separaIe schedule if there is insuffit
                                                                                                                                ~
              space in this table.)

              Coordinates                                                          Zone          Dalum                Local government
              (Note:place each set of coord ates in a separate row.)               reference                          area   (Ifapplicable)

              Easting         North              Latitude          longitude
                                                                                                 0 GDA94
                                                                                                 0 \M3S84
                                                                                                 0 other

              4.Total area of tbe prem           on which tbe   development is proposed (indicate square metres)               ::t
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                 to7        V’<\
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              5. Current usels of the premises (e.9.vacant land, house, aparlmem:bu            ing, cane farm etc.)



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              6.Are there any current approvals (e.g.a preliminary approval)assoc                  w this application? (Non-                            "":(;.k
                                                                                                                                                 ’:-?   -




              mandatory requirement)                                                                                                                    ,         "




              (2g    No        o       Yes-provide details below

              list of approval reference/s                         Date approved (ddlmmlyy)             Date approval lapses (ddlmmlyy)




              7.Is owner’s consent required for this application? (Referto notes at the end of this funn for more information.)


              Ig) No
              D      Yes-complete either Table G,Table H or Table I as applicab!e


              TableG

              Name of ownerls of the land

              lIWe,the above-mentioned CMIler/s of the land, consent to the making offhis application.

              Signature of ownerls of fhe land


              Date


              TableH

              Name of ownerls of the land

              oThe owner’s w            n consent is atl:ached or wiD be   provided septo the assessment manager




          I   Table I

              Name of ownerIs of the land
                                                                                                                                                                      I
          4
                                                                                                              IDAS form 1-Application details
                                                                                                                Version 2.0 17 December 2012