Signed_CouncilCDAForm · 132005.1133.06

3. Nature of request (please tick ALL applicable categories)
x     To change the development              x     To change the development                    To extend the relevant period
      approval                                     conditions                                   before lapsing
Please attach documentation outlining the detail of and the reasons and justification for the requested change or
extension.


4. Location of the premises
Unit No.                      Street No                     Street Resort Drive
Suburb      Noosa Heads                                                      State QLD                   Postcode     4575
Lot no.                       Plan type & plan no.
    Lot 7                     SP178340 (formerly Lot 3 on SP221524)




5. Concurrence Agencies
Was there one or more concurrence agencies involved in the original approval?                    No
                                                                                              x Yes-provide details below
Note – Under s372 of the Sustainable Planning Act 2009 the person making the request is required to give a copy of this request to all
concurrence agencies.
Concurrence Agency                                                                            Date copy given
Department of Natural Resources and Mines - via SARA                                          08/09/16 - SPD-0816-029646




6. Pre-request response notice
Has a pre-request response been given by a relevant entity (e.g. a concurrence agency) for this request?
x No                                                               Yes
If yes, please attach a copy of the notice.


7. Owner’s consent
Is the owner’s consent required for this request?                     No
                                                                   x Yes– complete either Table A or Table B below
Note – If more than one owner of the land all owners’ details are required


Table A – owner’s consent provided on form                               Table B – owner’s consent provided on form
                                                                                             Altum Properties No. 4 Pty
Owner’s name/s                                                           Owner’s name/s
                                                                                             Ltd
I/We, the above-mentioned owner/s of the land, consent                   x The owner’s written consent is attached.
to the making of this request.

Signature/s


Date




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