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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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Table E

 

Name of owner/s of the land

 

 

EC] The owner’s written consent is attached or will be provided separately to the assessment manage

 

 

Table F

 

 

Name of owner/s of the land Mona Bercy k ANY Quon ar8.

 

[Mey making this application, I, the applicant, declare that the owner has given written consent to th
application.

 

e making of the

 

 

 

[AH No E] Yes—complete table G

 

Table G—state owned resources (provide details for each state resource in a separate table)

 

Nature of state-owned resource

 

Nature of evidence required (tick the

evidence to this form)

C] Evidence the chief executive of the department ad
resource is satisfied the development is consisten
of, or an entitlement to, the resource

L] Evidence the chief executive of the department ad
resource is satisfied the development application
absence of an allocation of, or an entitlement to, t

 

 

applicable box and attach a copy of the [_] Evidence of an allocation of, or an entitlement to, the resource

ministering the
t with an allocation

 

ministering the

may proceed in the
ihe resource

 

 

 

[% adjacent to a water body, watercourse or aquifer (e.g. creek, river, lake, canal)—complete table
| on strategic port land under the 7ransport Infrastructure Act 1994—complete table |

C] in a tidal water area—complete table J

 

Table H Name of water body, watercourse or aquifer

 

 

Neos Ridkee/

 

 

 

 

4 Application detail
Version 1.0 18 D

is IDAS form 4
lecember 2009
'

 

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