Request a Change to Existing Approval & Response to Show Cause Notice -142008.1704.4

 7. Does the request involve a state resource prescribed under the Sustainable PlanningRegulaton 2009, schedule
 14? (e.g. the application involves state land, or taking quarry materials. Refer to the notes at the end of this form for more
 information)

       No                    Yes-the written agreement of the chief executive from whom evidence would need to be obtained
 7                    q
                             under the Sustainable PlanningAct20o9, section 254(1) must be attached.



 8. Has a pre-request response notice been given for this request?

       No
 q

       Yes-a copy of the pre-request response notice must be attached to this request
 q


 9. Is a copy of this request required to be given to another entity under section 372 of the Sustainable PlanningAct
 2009? (refer to notes at the end of this form for more information)

 q     No

 q     Yes-complete Table F


Table F

A copy of this request has been provided to the entities identified below (provide details for each entity given a copy of the
 request and the date the copy was given)

 q    Assessment manager for the
      original application

q     Concurrence agencies for the
      original application

q     Any other entity prescribed by
      a regulation



 io. Provide details of any other supporting information attached to this request




Notes for completing this template
. This template is not an approved form under the Sustainable PlanningAct2oo9. The entity responsible for deciding the
  request may have their own form for the purpose of making a written request to change an existing development approval.
  A change to an existing development approval may involve:
          a change to an approval given by the assessment manager
  o       a change to a condition imposed by a concurrence agency
  o       a change to an approval given by the Minister under a Ministerial call in
  o       a change to a condition imposed by the Minister under a Ministerial direction
 o        a change to an approval given by the Planning and Environment Court


                                                                                                  Version 1.1 March 2010