Application for Permit to Damage Vegetation - OPW13/0927

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    8. Identify if any of the followIng apply to the premises (Tick applicable box/es.)


    0 Adjacent to a water body, watercourse or aquifer (e.g.creek, river, lake, canal)-complete T                                                                                                 eK


    0 On strategic port land under the Transport Infrastructure Act 1994-complete Table l
    0 In a tidal water area-complete Table M
    0 On Brisbane core port land under the Transport Infrastructure Act 1994 (                                                                                          ble requires completion)


    0 On airport land under the Airport Assets (Restructuring and Dispos                                                                        Act 2008 (notable requires completion)



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    Table K                                                                                                         /
    Name of water body, watercourse or aquifer                                                          /
                                                                                           /
                                                                                      ./


    Table L                                        /
    lot on       plan description for strategic p~nd                                                                        Port authority for the lot


                                                            /
                                                      /



    Table M                     /
    Name of         local gove~nt for the tidal                    area        (if applicable)                              Port authority for the tidal area (if applicable)

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    9.Are there any-existing easements on the premises? (e.g.for vehicular acce                                                                                         ,electricity, overland flow,water
    etc.)

    o No                      D        Yes-ensure the ty                          Ion and dimension of each easement is included in the                                                           plans submitted


    10. Does the proposal Include new building work or opera                                                                                  on the               premises? (Including any services.)

    o No                      0                                            ,
                                                                               acation and dimension of proposed works are included in plans submitted



    11. Is the payment of a portable long service leave Ie                                                              cable to this application? (Referto notes at the end’
    of this form for more information.)


    o No-go to question 13

     12. Has the portable long service leave levy been paid? (Referto                                                                           at t                   nd of this form for more
    information.)
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    o           No

                                                                                                     ication the yellow local government/private certifiers copy of the
    o Yes-complete Table N and submit with this
                receipted QLeave form

    Table N

    Amount paid                                                        QLeave project number (6digit number starting with A, B, E, L or P)




    5                                                                                                                                                                                    IDAS form 1-Application details
                                                                                                                                                                                              Version 2.0 31 March 2013