14623 DA - Change a development approval [As Published] · 131998.981605.2

OOO

 

 

' Table: €—premises.coordinates (appropriate for development.in remote areas; over part of a lot or in water e.g. channel
‘| dredging in Moreton Bay)’ - ia a

 

‘| Zone ‘Datum‘ Local government _

 

Northing .

Coordinates .
,| (note: place each set of coordinates in a separate row) . .. | reference ‘atea (if applicable)
-Easting

Latitude | Longitude

 

 

 

[)-epa94
}.L] weses
(] ‘other

 

 

 

 

 

 

-5. Details. of the proposed change

 

 

News

\

 

 

 

6. Is owner's consent required for this request? (refer to notes at the end of this form for more information)

 

[] No

[¥] Yes—complete either table D or table E as applicable

 

Table D

 

Name:of owner of the land

See Mbackecl  Qew 1 Cinas)

 

\, the above-mentioned owner of the land, consent to the making of this request.

 

: Signature‘of owner of the land

 

Date

 

 

Table E

 

Name of owner of the land

 

 

 

[-]the owner’s written consent is attached

 

 

 

Request to change an existing approval template
Version 1.1 March 2010