Development Application Vegetation Removal Idas Forms 1 & 6 - OPW120597 · OPW12/0597

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                                                               use of
    D material change of                                                       premises

    D building work
    D operational work
    D reconfiguring lot                            a



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      [JI development permit                                                   c:i’ preliminary approval                                                          D                 both-provide details below




     D             No


     D Yes-complete table A and then go to question 5

      Table A-name of each local government area in which the mobile and temporary ERA is proposed to operate




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       Table B-street address/lot for the premises or street address/lot on plan for the land adjoining or adjacent to the
        premises
                           treet address/lot on the plan

                   ~      street address/lot on plan for the land adjoining or adjacent.to the premises (appropriate for development
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                                                                                                                                                                                                                                                                                    in

                          water e.g. jetty, pontoon)


         Street address                                                                                                                                          Lot on plan description                                    Local government area
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         Unit           Street               Street name and official suburb/                                                              Post-                  Lot no.                   Plan type

             no.         no.                 locality name                                                                                 code                                             and plan nb.




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                                    2                                                                                                                                                                               Application details-IDAS form 1
                                                                                                                                                                                                                           Version 1.0 18 December 2009