Development Application - Part 1 of 2 - IDAS Forms 1 & 6 and Checklist - OPW13/0502

        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 ofthe premises on which the development is proposed Ondicate square metres)                 .~Il   III
                                                                                                                                    "..I
                                                                                                                               pj
                                                                                                                  J:!,




    I   760m2

        5. Current use/s ofthe premises (e.g.vacant land, house, apartment building, cane farm etc.)




I       House




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



        x      No      D     Yes-provide details below

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




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


        X      No

        D      Yes~omplete either Table G, Table H or Table I as applicable

        Table G


        Name of ownerls of the land


        IM/e, the above-mentioned ownerls of the land, consent to the making of this application.

        Signature of ownerls of the land


        Date


        Table H

        Name of ownerls ofthe land


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


I       Table I

        Name of ownerls of the land


    4                                                                                                 IDAS form 1-AppJicafion details
                                                                                                       Version 2.0 17December 2012