132006.823.7 Development Application part 1 of 2 Request to Change Approval form, idas forms A & form 2 5 Morwong Dr Noosa Heads

INTEGRATED PLANNING ACT 1997                                                                                                                                    Part A, Versi             if




 NOTE: Answer all questions unless directed to go to a




 Company or orga lNation name (if a

 Individual a licant,`Corrtact person (if there is m           her one applicant, provide additional applicant d

      Title 1                                                                                       Last      '
                            First name
                                                                                                    name
                                                                                                              L_
      Postal address                                                                /.r,9' ®af


      Facsimile number




1.   Identify the premises by completing Table A, or 7^ bin B and/or Table C (ensure adequate information is given to identify the premises)
          It the application is for a mobile and temporary Environmentally Relevant Activity (ERA), complete Table A only. Then go In o2
                                      Name of each local government area in which the mobile and temporary ERA is proposed to operate




            Street address for the premises
      (I)   Rr Street address i lot on plan for the premises (,pons . =ate for most applications including building a,:,:, licatu
      (1)   Q Street address ;lot on plan for the land adjoining or adjacent to the premises tApprnpriate fr.=r dedetautnant in watere gg.,ctfy, pontoon
                   efe) (Note: Lot on plan details may be, obtained from title documertss a 'Rate`notice, or from the local govermment )

                                                    Street address                                                  Lot on plan description
                                       __........ .. _._..___.._.
                                                        .
            Unit      Sheet                                                                         Post                           Plartt} peand
            No.
                                        Street Name and chic       rbrrrb r e liC" name                           o t r.
                       tdo.     i                                                                   C ode                           Plan Number

                                                                                                                     '-r .111'e>1




AND / OR
            Coordinates and/or a map of the premises (Appnoprateford                      lop,                             rpa=t of a lot, in v Ater (e.g, r.,haiinei dredohgg in

                                             Coordinates                                                                                                            Local government ar
                               piece each e l ,of ccordnales in, a sc^eamte' m,.e
                                                                                                                                                                            (Ii appiica




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