Request to Change an Application 132004.5744.03

    To change the development                         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.




Was there one or more concurrence agencies involved in the original approval?

                                                                                                  D 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




       a   pre-request response been given by a relevant entity (e.g. a concurrence agency) for this request?
                                                                   DYes

If yes, please attach a copy of the notice.




                                                                            s-   complete either Table A or Table B below




Table A      -
                 owner’s consent provided on form


Owner’s name/s


I/We, the above-mentioned owner/s of the land, consent
to the making of this request.
                                                                                                                             L-T1)
Signature/s




2 of 4      2011/12 Regional Strategy and Planning Request to Change Existing Approval and/or Extension to Relevant Period FM401


[OCR of page images]
  
  

3. Nature of request (please tick ALL applicable categories)

|(Y To change the development O_ Tochange the development WY 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. StreetNo “SS [Street WALTER HAY DRIVE

Suburb UCOSAVILLE. ‘State @Qup> |Postcode U-Sé6
Lot no. Plan type & plan no.

Zo | SP \b2.077

 

 

}
|

 

 

 

5. Concurrance Agencies

 

Was there one or more concurrence agencies involved in the original approval? KYNo
O 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

 

 

 

 

 

 

6. Pre-request response notice

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

 

 

7. Owner’s consent

 

| Is the owner's consent required for this request? ONo
WYes— 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

 

|

 

 
 

Date |
| | |
| Owrier’s etre) pssst ny ‘ ‘
| Table A — owner’s consent provided on form
t 2 — '
| I/We, the above-mentioned owner/s of the land, consent | N
| | Owner's namels 2UNTEY CVG

 

to the making of this request.
|

\NILLAGCES Pry L

a The owner's written consent is attached.

 

 

| Signature/s pd

 

2o0f4 2011/12 Regional Strategy and Planning Request to Change Existing Approval and/or Extension to Relevant Period FM401