OPW14/0010 - Vehicle Crossover application -

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


0      NO       o      Yes-provide     details below

list of approval reference/s                            Date approved (ddlmm/yy)                  Date approval lapses (ddlmm/yy)



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

       No

ffi" Yes-{;omplete      either Table F. Table G or Table H as applicable

Table F

Name of ownerls of the land

I~     the above-mentioned ownerls of the land. consent to the making of this application.

Signature of ownerls of the land


Date

TableG

Name of ownerls of the land               I
o The owner's written consent is attached or will be provided separately to the assessment manager.
Table H

Name of ownerls of the land               I
o    By making this application. I. the applicant. declare that the owner has given written consent to the making of the application.

7.     Identify If any of the following       apply to the premises (Tick applicable boxles.)

o      Adjacent to a water body, watercourse or aquifer (e.g. creek. river, lake, canal)-complete              Table I

o      On strategic port land under the Transport Inlrastructure Act 1994-complete              Table J

o      In a tidal water area-{;omplete        Table K

o      On Brisbane core port land under the Transport Inlrastructure Act 1994 (No table requires completion.)

o      On airport land under the Airport Assets (Restructuring and Disposal) Act 2008 (no table requires completion)


Table I

Name of water body, watercourse or aquifer



Table J

Lot on plan description for strategic port land                              Port authority for the lot




                                                                                                          IDAS form I-Application  de/aIls
                                                                                                                 Version 3 0-1 July 20 13