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CCE03122012_0000 · OPW13/0059

Attached to the e-mail Application for permit to damage vegetation - 291 Gympie Terrace Nossaville.

of 13

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[| material change of use of premises

| uilding work
operational work

L] reconfiguring a lot

 

[| preliminary approval ,

L | both—provide details below

 

 

 

 

| Yes—complete table A and then go to question 5

 

 

Table A—name of each local government area in which the mobile and temparary ERA is proposed to operate

 

 

 

 

 

premises
[7 street address/lot on the plan

water e.g. jetty, pontoon)

Table B—street address/lot for the premises or street address/lot on plan for the land adjoining or adjacent to

he

| street address/lot on plan for the land adjoining or slacen to the premises (appropriate for|development in

 

 

 

 

 

 

 

 

 

 

 

 

Street address | Lot on plan description | Local government area
Unit | Street ) Street name and official suburb/ | Post- Lot no. Plan type (e.g. Logan, Cairns)
no. no. locality name code | and plan no.
O24 | SYM OIE, TERMACE 4sblo \Geoonds |S Now 5 ~ Seencttidé
Ne@SAV/OLE 70294 | past
2 Application detaits—iOAS form 1

 

Version 1.0 18 December 2009

 

 

 

 

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