Application for Permit to Damage Vegetation - OPW13/0927

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        5. Are there any current approvals (e.g.a preliminary
                                                                             approval) associated with this application? (Non-
        mandatory requirement)
                                                                                                                                                                 I
        !
        No o Yes-provide details below
        List of approval reference/s                                 Date approved (dd/mm/yy)                           Date approval lapses (dd/mm/yy)




        6. Is owner’s consent required for this application?
                                                                           (Referto notes at the end of this form for more information.)

        g No
        D Yes-complete either Table G Table H or Table I as applicable
                                                0



                                                                                                                      /
    Table G
                                                                                                                 /
    Name of ownerls of the land
                                                                                                              /
    I/We, the above-mentioned owner/s of the land, consent to the
                                                                                  makinp-6t this application.
    Signature of owner/s of the land
                                                                                /
    Date
                                                                       L
                                                                          "


    Table H
                                                                      /
    Name of owner/s of the land
                                                                     /
    D The owner’s written consent is attach~ will be provided separately to the assessment manager

    Table I
                                                /
    Name of owner/s of the land
                                         /
    D By making this       application6, the applicant, declare that the           owner has                  given written consent to the making of the
    application.



    7. Does the application Involve a state resource?
                                                            (E.g.the application involves taking water or quarry material, or
    interfering with the flow of water. Refer to the notes at the end of this form for more information)(Non-mandatory
    requirement.)

    lit No                      o Not identified whether or o Yes-complete Table J
                                       not the application
                                       involves a State
                                       resource




    TableJ

    Nature of state-owned resource (if identified)



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                                                                                                                              IDAS form 1-Applicatiof? details
                                                                                                                                   Version 2.0 31 March 2013