08/0749 - Op Works - Dam [As Published] · 142008.749

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INTEGRATED PLANNING ACT 1997 Part A, Version 3.1, 3 March 2008

   

 

Form 1 Development Application

Part A

Common details

OTE: Answer all questions unless directed to go to a particular question. Refer to the end of the form for advice on how to complete this form.

 

Applicant détails (The Applica is the person responsible for making the apphcaton and need not be the owner of the land. The Applicant is responsibte for ensuring the
Je‘ormasan prowded on the IDAS Appiice"9n Form is correct. Thrs xv‘ormenon is fe! ed upon by the Assessment Manager and any referral agencies when assessing and
Sdeuid'ng this application By lodging tvs eppiicaton, the Appicent incurs the ob! gaions and responsib'“ies prescribed by the IPA. Any development permit or pre“nt-nary
approval that may be issued a8 a Consequence of this apptca'.on w.5 be issued lo the App*cant.}

 

 

 

 

Company/organisation name (if applicable) [

 

Individual applicant/Contact person (If there is more than one applicant, provide additional applicant details on an attachment to this form)

Title (wr | First name Lastname |McCosker

Postal address [Po Box 1125 , Gladstone .Qld 4680

Contact telephone number 107 49700100 Mobile phone number 0408 372 708
Facsimile number 07 49722304 e-mail address [email protected]

 

 

 

 

 

 

 

 

 

 

 

 

 

Details of the premises (ie the land on whch the development is propased = refer ta he advice atthe end of the form) oe }
1. Identify the premises by completing Table A, or Table B and/or Table C (ensure adequate information is given to identify the premises)
Table A Ifthe application is for a mobile and temporary Environmentally Relevant Activity (ERA), complete Table A only. Then go to Q2.

 

| Name of each local goverment area in which the mobile and temporary ERA is proposed to operate
{1

 

 

 

 

OR
Table 8 Street address for the premises (tick applicable bax/es below and insert property description in the table. Identify each lot in a separate row.)

(i) {XJ Street address / lot on plan for the premises (Appropriate for most applications including building applications), OF

(i) [7] Street address /lot on plan for the land adjoining or adjacent to the premises (Appropriate for development in water e.g. jetty,
pontoon etc) (Note: Loton plan details may be obtained from tite documents, a ‘Rate’ notice, or from the local government.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

} Street Address Lot on pian description
Ta Seer Blan type and Local government area (e.g. Logan, |
No. | No. Street Name and official suburbflocality name | Post Code} Lot NO. | pian Number Caims)
4 56 BEECHTREE ROAD.BLACK MOUNTAIN 4563 4 849480 SUNSHINE COAST
AND/OR
Table C Coordinates and/or a map of the premises (Appropriate for development in remote afeas, over part of a fot, in water (e.g. channel dredging in Moreton
Bay) etc.)
Coordinates
{Note: place each set of coordinates in a separate row) Zone Local government area
: , : . Reference Datum (if applicable)
Easting Northing Latitude Longitude
1 ([] depass
C1 weses
O Other -

 

 

 

 

 

 

 

 

 

 

2. Identify if any of the following apply to the premises by completing Tables D, E, or F. (Note: in most instances, the premises will not involve any of
the following characteristics, however some applications may involve one or more of these characteristics - complete only if applicable)