Re-lodged application MCU16/0121

                                                                                  Department of Infrastructure.   local Government and Planning




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

lit      No         o     Yes-provide        details below

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



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

o        No
I2f      Yes-<:omplete     either Table F, Table G or Table H as applicable

Table F

Name of ownerls of the land                                           /,        :ow COM/"6
!/We, the above-mentioned         ownerls of the land. consen to the making of this application.

Signature of ownerls of the land


Date

Table G

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
                                              ,
0 By making this application, I, the applican~ 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 box/es.)

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 Infrastructure Act 1994-complete                  Table J
o        In a tidal water area-complete        Table K

o        On Brisbane core port land under the Transport Infrastructure Act 1994 (No table requires completion.)
o        On airport land under the Airport Assets (Restructuring and Disposal) Act 2008 (no table requires completion)
o        Listed on either the Contaminated Land Register (CLR) or the Environmental                   Management Register (EMR) under
         the Environmental Protection Act 1994 (no table requires completion)

Table I

Name of water body, watercourse or aquifer




TableJ

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

                                                                                                              IDAS form I-Application details
                                                                                                                  Version 4.2-3 August 2015