132007.557.2 Development Application part 1 Request to Change Existing Approval Form PLANS 22 Northeden Court Cooroy

                                                                                                      /3a 00 7 . ss^.                          2.
 Sunshine Coast                                              Request to Change Existing Approval and/or
     Regional Council                                               Extension to Relevant Period

NOTES:                                                                      Which entity issued the approval?
ALL questions MUST be completed unless the form indicates                         Sunshine Coast Regional Council
otherwise.                                                                        Other entity -please specify:   c 3O S f-1                   Y1 ^E
This form must be submitted to Council accompanied by the
applicable fee.                                                             Is the approval for a mobile and temporary ERA?

Attach extra pages if there is insufficient space on the form.             7      No
If Council was the Assessment Manager for the existing approval,                  Yes - complete below
and the approval was issued by the Court, then:-
                                                                           Insert the name of each local government area in which the
(a)     a request to change the development approval and/or                mobile and temporary ERA is proposed to
        conditions is made to the Court; and
                                                                           operate/operating.
(b)     a request to extend the relevant period for the approval is
        made to Council.
All terms used on the form have the meaning given in the
Sustainable Planning Act 2009 or the Sustainable Planning
Regulation 2009.                                                           3.          Nature of request

                                                                            Please tick ALL applicable categories
1.        Details of the person making the request
                                                                                  To change the development approval
Full name - individual or company                                                 To change the development conditions
"^',1 C_)rtcN -L-        m ` C                                                    To extend the relevant period before lapsing

Contact name -for company                                                             Please attach documentation outlining the details of
                                                                                      and the reasons and justification for the requested
                                                                                      change or extension.
Postal address
                                                                           4.          Location of the premises

_C_ ego R.O ^                                                              Street address
     Grp                                    Postcode LLS k,                 Unit no.     Street no,    Street name

Contact phone number                Fax number - if applicable                           I             ^f^Dtii H
                                                                           Suburb                                              Postcode
5 L-L), -D1G 1 O k                                                    1    elcocZA tit
Mobile number -if applicable
                                                                            Lot and plan description
(0 VL-1 %0                      6
                                                                            Lot no.      Plan type & plan no.
E-mail address -if applicable



2.        Details of the existing approval                                                                                                        1


Type of approval -please tick ALL applicable categories
       Development Permit
       Preliminary Approval                                                5.          Concurrence Agen
       Compliance Permit                                                   Was there one or more conct1x ttce agencies involved in
       Material Change of Use                                              the original approval?                  /   '   w




       Reconfiguring a Lot
       Operational Works                                                         Yes - provide details below
                                                                          IZI No
       Building Works                                                      Note - Under s372 of the Sustainable Planning Act 2009 the person
       Plumbing or Drainage Works                                          making the request is required to give a copy of this request to all
                                                                           concurrence agencies.
       Compliance Certificate
      i Environmentally Relevant Activity (ERA                             Concurrence Agency                                  Date copy given

Application number              Date issued                                                                                        /     /

                                                Ito                          Fpm ^>> L..ec.cnter . ....
                                                                                - 4 MAY 2011

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