Sandpiper Request to Change Existing Approval 150915 · 132007.1181.02

4. Location of the premises
Unit No. 3                    Street No 33                  Street     Hastings Street
Suburb         Noosa Heads                                                 State QLD                     Postcode 4567
Lot no.                       Plan type & plan no.
   5                               SP251687




5. Concurrence Agencies
Was there one or more concurrence agencies involved in the original approval?                 X No
                                                                                              
                                                                                               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?
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
                                                                                               Spurgin Assetts Pty Ltd
Owner’s name/s                                                           Owner’s name/s

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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