132005.2124.3 Request to Change an Existing Approval - part 1 of 2 IDAS form - 41 Hastings St Noosa Heads

2. What are the details of the existing approval sought to be changed?


Type of approval                Identification number     Date decision notice      Name of entity that issued the approval or
                                                          or negotiated             imposed the condition sought to be changed
                                                          decision notice
                                                          issued

        Development
q
        permit

        Preliminary
q
        approval



3. Is the approval for a mobile and temporary environmentally relevant activity (ERA)?


q       No

q       Yes-complete table A and then go to question 5


Table A-name of each local government area in which the mobile and temporary ERA is proposed to operate/ is operating




4. Location of the premises (complete table B and/or table C as applicable. Identify each lot in a separate row)


Table B-street address/lot for the premises or street address/lot on plan for the land adjoining or adjacent to the
premises

       © street address/lot on the plan

       q street address/lot on plan for the land adjoining or adjacent to the premises (appropriate for development in
              water e.g. jetty, pontoon)

Street address                                                        Lot on plan description        Local government area
                                                                                                     (e.g. Logan, Cairns)
Unit      Street       Street name and official suburb/     Post-     Lot no.      Plan type
no.          no.       locality name                        code                   and plan no.


3         y- I          NA57'S'T                           L^-5^          3        13vf'z .           5c RC




                   2                                                            Request to change an existing approval template
                                                                                                        Version 1.1 March 2010