121206_L27_Certifier_MCU Consent · MCU12/0201

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

I, Santon GALLARD ; [insert name in full]

as owner of premises identified as follows

1% Aeosveveh tle , MeocA Meros (L24 Spiece2e)

linsert 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 Building Certifiers

\
on the premises described above for the purposes of:

MLU SINGLE STotE] Hote

[insert detgijs 9f the proposed development, e.g. material change of use for three storey apartment building]

[signature of owner]

1% oo IR:

 

signed on the _ ob _ day of

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

 

PP2_0034_43 (B) Version#1 10.12.09