Council archive · source document
NC Pre Request Response App form Signed · 131999.982963.5
Attached to the e-mail Change to DA - Pre Request Response - 131999.982963.5.
x ‘ NOOSA COUNCIL Pre-Request Response Application
Planning Act 2016
ALL questions MUST be completed unless the form indicates otherwise.
This form must be submitted to Council accompanied by the applicable fee.
Attach extra pages if there is insufficient space on the form.
All terms used on the form have the meaning given in the Planning Act 2016 or the Planning Regulation 2017.
1. Details of person making the request
Full name — individual or company Dr Rod and Dr Caroline Warren
Contact Name — for company Nadine Gorton of Martoo Consulting
Postal address Po Box 1684
Suburb Noosa Heads [ State Qld | Postcode 4567
Business phone 54472364 [AH phone Mobile
Email address [email protected] Fax
2. Details of existing approval
Type of approval (please tick ALL applicable categories) Which entity issued approval?
Council
Planning & Environment Court
Minister (under part 11, division 2)
Other entity — please specify
Development Permit
Preliminary Approval
Material Change of Use
Reconfiguring a Lot
Operational Works
Building Works
Plumbing or Drainage Works
Environmentally Relevant Activity
Application number/council reference 12592DA Date issued 2003
Is the approval for a mobile and temporary ERA? O No O Yes —complete below
Insert the name of each local government area in which the mobile and temporary ERA is proposed to operate/operating
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3. Nature of proposed change/s (please tick ALL applicable categories)
To change the conditions issued by;
WY Planning & Environment Court
O Council (as a Concurrence agency)
O Minister
O Concurrence Agency — please specify:
O Other entity — please specify:
Please attach documentation outlining the detail of and the reasons and justification for the requested change/s.
To change the development approval issued by:
MM Planning & Environment Court
O Minister
O Other entity — please specify:
Privacy
Council will use any personal information provided for the intended purpose only and for remaining in contact with you. Council is authorised to collect
this information in accordance with the Local Government Act 2009 and other Local Government Acts. Your personal information is only accessed by
persons authorised to do so. Your personal information is dealt with in accordance with council's privacy policy.
www.noosa.qid.gov.au [email protected] T 07 5329 6500
PO Box 141 Tewantin Qld 4565 ABN 97 969 214 121
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4. Location of the premises Unit No. Street No 10 Street Bayview Road Suburb Noosa Heads State Qld Postcode 4567 Lot no. | aria) res rms em J 1 SP174659 me B Lear lame Pree (We, the applicant, declare that the above information is correct in all respects, at the time of lodgement of this application with Council. Should any of the details given in relation to this application be changed in the future, the applicant shall advise Council in writing prior to any such change being implemented. Signature W1 OAD F OX [Date 14.11.2018 YS OFFICE USE ONLY Application no. | Amount paid Date paid Receipt no. Initial Date stamp Receiving Officer Payment options In person 9 Pelican Street, Tewantin: 8.30 am to 4.30 pm Monday to Friday (excludes public holidays). By mail Cheque or money order to be made payable to Noosa Council. O Cheque lo Money order O Mastercard O Visa Card number Expiry date Amount $ Name on card Signature of cardholder Phone Is a receipt required? 0 Yes ONo tn payments made by credit card will incur a 0.50% surcharge (exempt of GST) to reflect the cost of fees charged for credit card ransactions. Page 2 of 2
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NC Pre Request Response App form Signed.pdfRelated documentApplication case desk ↗
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