IDAS form 1 · OPW12/0427

          [ii][i
r. What is the nature of development proposed? (tick all appticable box/es)

T material         change of use of premises

T building work
tr operationalwork
T reconfiguring lot      a


z. What type of approval is being sought?


I         development        permit I       preliminary approval
                                                                    e        both-provide details below




3. ls the apptication for a mobile and temporary environmentatly relevant activity (ERA)?


V       No


T 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




4. Location of the premises (complete table B and/or table C as appticabte. ldentifu each lot in a separate row)


Table B-street address/lot for the premises or street address/lot on plan for the land adjoining or adjacent to the
premises
       pf street address/lot on the plan
       l-l street address/lot on plan for the land adjoining or adjacent to the premises (appropriate for development in
              water e.g. jetty, pontoon)

Street address                                                     Lot on plan description        Local government area
                                                                                                  (e.g. Logan, Cairns)
Unit      Street     Street name and officialsuburb/     Post-     Lot no.      Plan type
no.          no.     locality name                       code                  and plan no.

                                                                                                      ,t/
              ?
                        fro furu S-/'nut                 ,.1b15-                                    -\l;n'ia14g (



                                                                                              App/ication details