04/4078 - Change to a Development Approval (Extension to Restaurant) [As Published] · 132004.4078.05

Part A, Version 3.1, 3 March 2008

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Applicant details. (7he Applicant is the person responsible for making the application and need nat be the owner of the Tarra. pplicant is responsible for ensuring the
information provided on.the [OAS Application Form is correct. This information is relied upon by the Assessment Manager and any referral agencies when assessing and
[deciding this application. By lodging this application, the Applicant incurs the obligations and sesponsibilities prescribed by the IPA. Any development permit or préliminary
lapproval that may be issued as a consequence of this application will be issued to the Applicant.)

 

 

 

 

Company/organisation name {if applicable} |Noosa Heads Surf Life Saving Club |

 

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

Postal address [crmartoo Consulting Po Box 1684 NOOSA HEADS Q 4567

Contact telephone number 5455 5425 Mobile phone number [ti tt”~—‘izY
Facsimile number 5455 §725 e-mail address [email protected]

 

 

 

 

 

 

 

 

 

 

 

‘Details of the premises (ie. the land on which the development is proposed - refer to the advice af the end of the form) |
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 If the application is for a mobile and temporary Environmentally Relevant Activity (ERA), complete Table A only. Then go to Q2.

 

 

to operate

 

 

 

 

| 1
OR
TableB Street address for the premises (tick applicable box/es below and insert property description in the table. Identify each lot in a separate row.)
()  {] Street address / lot on plan for the premises (Appropriate for most applications including building applications); OF

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

* Street Address Lot on plan description] ~~ .
Tar Sizer a - "Bian iype and Local government area (e.g. Logan,
No. | No. Street Name and official suburbvocalty name Post Code Lot No: Plan Nuriber_|. 7 Cairns)
4 61 Hastings Street Noosa Heads 4567 3 CP 862568 —_| Sunshine Coast Regional Council
AND/OR
Table Coordinates and/or a map of the premises (Appropriate for development in remote areas, over part of a lot, 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 _]
= — —— ———1 Reference | Datum (if applicable)
-  Eastirig Northing Latitude. . Longitude foe °
1 1] pepass
CO weses
CD 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)