Appendix C - Owners Consent

Individual owner’s consent to the making of a
development application under the Sustainable Planning Act 2009

_ Alban Hugin Forge Hirata ttn

as owner of premises identified as follows

44 Nandroya Road, Cooroy described as Lot 2 on RP193949

[insert street address, lot on plan description, or coordinates of the premises the subject of the application]
consent to the making of a development application under the Sustainable Planning Act 2009 by
Noosa Town Planning : __[insert name of applicant]

on the premises described above for the purposes of:

Material Change of Use — Transport Use — Type 3 (Depot)

[insert details of the proposed development 4-g. material change of use for three storey apartment building]

x - Wd na - “] — a (signature of owner]
. —
signed on the dS . . day of Aes US t 20 / S

The Sustainable Planning Act 2009 is administered by the Department of Infrastructure and Planning, Queensland Government.