Development Application for permit to damage vegetation - OPW13/0151

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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 area of the premises on which the development is proposed (indicate square metres)


    I          Setb~Z_

             5. Current use/s of the premises (e.g. vacant I and, house, apartment building, cane farm etc.)




    I          \4c::> v Se....




             6. Are there any current approvals (e.g.a prel iminary approval) associated with this application? (Non-
             mandatory requirement.)

             ~NO                    D    Yes-provide details below

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




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


             ~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 wiII be provided separately to the assessment manager


        I:   Table I

             Name of owner/s of the land                      I
         4                                                                                                  IDAS form 1-Application details
                                                                                                             Version 2.017 December 2012