Application form Heritage Reporting a discovery Use this form to report a discovery of an artefact under the Queensland Heritage Act 1992. 1. Applicant details NAME POSTAL ADDRESS TELEPHONE POSTCODE MOBILE PHONE E-MAIL 2. Person/s who made the discovery details (if different from applicant) NAME POSTAL ADDRESS TELEPHONE POSTCODE MOBILE PHONE E-MAIL 3. Discovery details DATE OF DISCOVERY DESCRIPTION OF THE DISCOVERY Describe: the type, size and number of artefacts found (e.g. two ceramic sherds 3cm x 6cm, six 750ml beer bottles). if artefact/s were found above or below ground or submerged. If found below ground, note approximate depth. any distinguishing features, e.g. decorative surfaces, patterns or identifying marks if artefacts have been disturbed or appear to have been moved from their previous location. DESCRIPTION OF THE SITE WHERE DISCOVERY WAS MADE Describe: the extent of the site of the discovery how the site is currently used how easy it is to gain access to the site if and how the site has been disturbed. SITE PLAN Include: all important elements clearly labelled in their approximate locations dimensions of significant elements and the distances between them the extent of the site of the discovery. EACH GRID SQUARE MEASURES 1CM X 1CM PLEASE ENTER APPROXIMATE SCALE USED: 1CM = NW SW Page 2 of 4 • 151104 NE SE Department of Environment and Heritage Protection www.ehp.qld.gov.au 4. Discovery location and spatial co-ordinates ADDRESS POSTCODE LOT ON PLAN NUMBER/S TENURE (IF APPLICABLE) LOCAL GOVERNMENT AREA MAP GRID ZONE OF EASTING NORTHING AUSTRALIA/PROJECTION: 54 55 56 LONGITUDE LATITUDE ACCURACY +/- m (IF GPS) RECORDED USING DIFFERENTIAL GPS AERIAL PHOTOGRAPHY HAND-HELD GPS GIS MAP READING LANDMARK BEARING ESTIMATION 5. Photographic record Attach photographs to this application that show the artefacts and the site where they were found. Number all photographs and complete the following index sheet. Add more rows if needed. Maximum file size for digital images attached to this form is 250kb each. DATE AND TIME TAKEN PHOTOGRAPHER COPYRIGHT PERMISSIONS IMAGE NUMBER Page 3 of 4 • 151104 FILE NAME DESCRIPTION Department of Environment and Heritage Protection www.ehp.qld.gov.au 6. Attachments LIST OF ATTACHMENTS Include a list of attachments submitted as part of this application (e.g. consultant’s reports, maps or historical research). For each attachment listed provide title, author and attachment copyright permissions. 7. Lodgement Send one copy of the completed form and any attachments to: Email: PaLM@ehp.qld.gov.au OR Post: Permit and Licence Management Department of Environment and Heritage Protection GPO Box 2454 Brisbane Q 4001 Further information call 13 QGOV (13 74 68) and ask to speak to a Heritage Branch Officer email archaeology@ehp.qld.gov.au visit www.qld.gov.au/environment/land/heritage/ Page 4 of 4 • 151104 Department of Environment and Heritage Protection www.ehp.qld.gov.au