07/1728 - MCU - Detached House [As Published] · 132007.1728

INTEGRATED PLANNING ACT 1997 Part A, Version 2.4, 29 May 2006

AS Form 1 Development Application

 
  

Common details &

QO.

 

The completion of afl applicable on Part A Is mandatory for all appfications. Part A must be accompanied by the completed 1DAS Assessment Checklist if
required, and by one (1) or more other completed parts of the Form as required. For more information on the parts of the Form refer to www.ipa.aid.gov.au.
( Any information requested In the form may be provided in an attachment to the appfication. For further information about completing the following details, refer to Guide 1,

 

 

 

i Description of land 1. Street address: (nctudinghouse number, street name, suburbocality name & postcade) (if applicable)

* Allland the subject of the application, must be —

ened. However, a decepion of be land st R N WE
eee eee 2. Name of water body or watercourse, within which the development is proposed: (i eppiicable)

 

EE a ate vty Linpcme Nir
nt is proposed within a water body or
watecourse. 3. Coren description (eg. Lot 123 on RP 4567)! GPS coordinates:

mpletin: - Most land can be
@ denied by lot on plan description These dtas (\p- \o
can be obtained from title documents or through the

 

 

 

 
  

 

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local government. 4. The above deacipton is for: (tick applicable box)
+ However, ifthe land on which the development is [4(i) the land on which the development is proposed; or
nce cognate na ian aceon fie. [4A (ii) the tand adjoining the water body or watercourse, within which the development is
1 | watercourse) provide - proposed; or
‘0 afotingodacent io ne CL (iii) the water body or watercourse.
im sdonigiadacen nd (ee hr aoton Bay). 5. Shop / tenancy number: 6. Storey / level: 7. Total area of land: (my or ha):
, Advice for completing Q7 - Q7 does if th
development is within a water body or retake ° L = - L um _| ws nn
«Ailee for coma Ae Re aes a2. {8 Local government area in which the land js situated: (eg. Esk, Hervey Bay, Woocen etc.) (i applicable)
1 Note: Aroas below high water mark are not withi .
| pcal governments aa lose paneer under the > ae
| Local Goverment Act 1993. 9. Port authority for the strategic port tand or strategic port land tidal area on which the
| advice for completing Qs - 29 applies i development is proposed: (eg. Port of Brisbane, Port of Townsville) (if applicable)

| putlon! Oda! nea Fare datas ake a
{portland Sal area For mora details refer to Guide 11. |

 

 

 

 

Ffpoam details 10. Existing use of the land: (eg. vacant, single house, shop etc.)
' there is insufficient jailabt details be
_ provided in an attachment tothe application. my | Nee. |

 

t 11. Proposed use of the land: (eg. 6 unit apartment building, 30 lot residential Subdivision, ERA for aquacutture in
i ponds with a total area of 7 ha for which wastes are released into waters etc).

: L2 \exen Res Sence.

 

 

 

 

 

 

{Other applicable parts of Form 1 12. Other parts of Form 1 completed as part of this application: (eg. Part D, Part , etc)

‘Part A must afways be accompanied by other —_—
(Pannen be matey ot Senex =>
{when a part of Form 1 may apply refer to Guide 1,
fApplicant details 13. Applicant's name: ‘15. Contact person:
| Clearly identify who is making the application. The

sritintnced abe eae lta [Dares  Sesomna~ |] [Dies Seconpan |
; When signing and todaing this application 14. Contact number: 16. Facsimile number/e-mail address:

 

i The responsible for ensurl r :

emai pot Kare Teen . [OX Sut Sosa Sauidlsoonlen @ agent tam,
referral agency & the Chief Executive

+ ere eplicel) wl ty on ths formation when 17. Postal address:

pp secntis acme ortat gene Tp Ban WW Neos Sens. ASE

{must be shown, 18. Signature: 19. Date:

1 \E dW a