00154987.001

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                      INTEGRATED PLANNING ACT 1997                                                                                                    Part A, Version 2.4, 29 May 2006
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                          The completion of all applicable questions on Part A is mandatory for all applications. Part A must be accompanied by the completed IDAS Assessment Checklist if
                               required, and by one (1) or more other completed parts of the Form as required. For more information on the parts of the Form refer to www.io2.ald.cov.gu.
                        Any Information requested in the form may be provided in an attachment to the application. For further information about completing the following details, refer to Guide 1.
                      Description of land                          1. .  Street address: fnctuding house number, street neme, suburb/ocality name & postcode) (if applicable)
                      Allland the subject of the application, must be
                      identified. However, a description of the and is not 30 anchorage noosa waters                                                      a
                          ired in relation to @ mobile or t      :                                                  tans     ‘                       :            ‘       .
                     Environmentally Relevant Activity (ERA).      2.    Name of water body or watercourse, within which the development is proposed: (if applicable)
                      development Is proposed within a water body or        -    —          —                                           ~
                     watecourse,                                   3.   Loton plan description (eg. Lot 123 on RP 4567) / GPS coordinates:
      @               identified by a lot on plan description. These details Kot   733      ow      Re $9736)
       ‘              Advice for completing Q3 - Most land can be              -
                        be obtained from title d ts or through th           :              i.             -      "
                      localgovennen.                            |  4.   Thédbove description is for: (tick applicable box)
                      However, if the land on which the davelopment is       (i) the land on which the development is proposed; or
                           ed d     ft have a lot on plan description (i.e.  as               wee                                           vy      .                       .
                      the developmest is proposed ina water both of fle CJ (ii)  the land adjoining the water body or watercourse, within which the development is
                      watercourse) provide ~                                      proposed; or                                                                          ,
                      0 be ton   an dae pion rthe                       [-] (ii) the water body or watercourse.
                                    description fo                           ses
                       i) GPS coordinates where there is no                          :                           .
:                     a adjcining/adjacent land (eg. in Moreton Bay). 5. Shop / tenancy number.           6.    Storey / level:              7.    Total area of land: {m? or ha):
                      development is within a water body or watercourse,
                    Advice for completing Q8 - QB applies if                                             ee           in  gh                                               a
                     development Is within a local government area. 8.  Local government area in which the land is situated: (eg. Esk, Hervey Bay, Woocuo etc.) (if appicable)
                      eng ii                            i
                     focal government's area unless provided for under the                  -
                     Local cmemmen an 1993. 08        '           9.    Port authority for the strategic port land or strategic port land tidal area on which the
                     Advice for completing Q9 - Q9 epplies                             ;            ,             .                         5
                     development is on stategic portland ora str xg     development is proposed: (eg. Port of Brisbane, Port of Townsville} (if applicable)
               /     Pro roca etal mh                             10.   Existing use of the land: (eg. vacent, single house, shop etc.)
                     Pole at                                         [singehowse
       A     \        RECE                                        11.   Proposed use of the land: (eg. 6 unit apartment buikding, 30 Jot residential subdivision, ERA for aquaculture in
             .                3 UN 2007                                ponds with @ total area of 7 ha for which wastes are released into waters etc). .                .
                      22              it                                 SESIQEMTIAL
                     othe Wb ateahte Fakts gf For      1       -|12.    Other parts of Form 1 completed as part of this application: (eg. Parl D, Pert/.elc)
                c> Fart     Atiust always be accopPaniethpy other
                 <” Cohalated parts of  Forme oigtoprtation about   ae
                     ped» Farag      Ty apply   fer to Gulde 1.                             :          ,                                      .                               TT
                     Appitcenddetais”                             13.  Applicant's name:                                   15.  Contact person:
                     applicant need not be the owner of the land.        Dion Gadd                                                Dion Gadd                                          .
                     When signing and lodging this application    14,  Contact number:                                    16.   Facsimile number/e-mail address:
                     The applicant is responsible for ensuring the    | o4i7eadi4                                  sid
                     informetion provided is correct The assessment      0417649414                                               0754553647
                     manager, any referral agency & the Chief Executive
                     {where applicable) will rely on this information when | 17. Postal address:
                      tha weed               ~ acontact person           3 Arkana Dr Noosa Heads                                       ws
                   must be shown.                                 18.  Signature:                                                        19,   Date:
                                                                                 He         /                                                 41/05/2007
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