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EarthCert°
PO Box 432, Pomona QLD 4568 * Ph 07 3063 9391 « [email protected] * ABN: 49 162 782 014
OWNER’S CONSENT TO LODGE
We, MCW TGAPMIALLE ERENCES , owner/s of
45.4 D7 HENDERS On) RAED . give EarthCert Pty Ltd
TIN BEER UA
permission to lodge the MCU application for the proposed building work at the above
address on my behalf.
Signed
cs
DAB eee DEN DY
=
MICA fer CVE eT
Name:
Date: a, GOLF /
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