10/0529- Retail Type Business 2 - Shop [As Published] · 132010.529

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8.'ls owner's consént required for this application? (refer to ‘otss at the erid-of this form for more information)

 

 

(J No

IX] Yes - complete either table D, table E or table F as applicable

 

Table D (note: do not complete this table if lodging the application on-line using Smart eDA)

 

 

Name of owner/s of the land

 

We, the above-mentioned owner/s of the land, consent to the making of this application.

 

Signature of owner/s of the land|

 

 

Date

 

 

Table E

 

 

 

Name of owner/s of the land

 

Ix] The owner's written consent is attached or will be provided separately to the assessment manager

 

Table F

 

 

 

Name of owner/s of the land

 

Oo By making this application, |, the applicant, declare that the owner has given written consent to the making of
the application.

 

 

 

 

 

 

 

 

L] _ adjacent to a water body, watercourse or aquifer (e.g creek, river, lake, canal) - complete table H

{1 __ onstrategic port land under the Transport Infrastructure Act 1994 - complete table |
(J _ ina tidat water area - complete table J

 

    

 

: "water, -etc:) 4

De

 

 

[—XJNo []Yes - ensure the type, location and dimension of each easement is included in the plans submitted

 

Application Details - IDAS form 1
Version 1.0 18 December 2009

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