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

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Table I                                Lot on plan description for strategic
                                                                                                                                                  ~                                                                                                                   Port authority for the lot

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Table J                                Name of local government for the tidal
                                                                                                                                             are~licable)                                                                                                             Port authority for the tidal area (if applicable)


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    ulNO D                                              Yes-ensure the type, location and dimension of each easement is included in the plans submitted




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                                       D                Yes-ensure the nature, location and dimension of proposed works are included in plans submitted




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     D Yes-complete table K.and submit with this application the yellow local government/private certifier’s copy of the
                            receipted QLeave form


    Table K                            Amount paid                                                                                Date paid                                                                            QLeave Project Number (6 digit number starting with A, B,
                                                                                                                                                                                                                       E, Lor P)




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      D                     Yes-please provide details below
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     Name of local government                                                                                                                           Date ofwritten notice given                                                                                                      Reference number of written notice given

                                                                                                                                                        by local government                                                                                                              by local government (if applicable)




                                        5                                                                                                                                                                                                                                                                   Application details-/DAS form 1
                                                                                                                                                                                                                                                                                                                   Version 1.0 18 December 2009