001AC752.001

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       INTEGRATED PLANNING ACT 1997                                                                              Form 2, Version 4.1, 3 March 2008
                 No         L]   Yes- Complete Table G. Submit, with the application. a copy of the notice required to be sent to each agency under
                                 IPA sections 3.5.22(1)(a) and 3.5.24(1}(b).
                       ;                ;     Each concurrence agency     «=                                     Date notice sent
       Table G    po                     ‘(use a’separate row for each agency)                         .                 to            :
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       10.  Does the request for change relate to an aspect of the approval that involved a building referral agency?
                 No         [] Yes - Complete Table H. Submit, with the application. a copy of thé notice required to be sent to each agency under ©”
                                 IPA section 3.5.24(1)(6).                                                                                .
                  Sordi          Se         Bach building referral agency.                          te            Date notice sent
       Table H    Beihigel SERE   geesinate (Use a separaté row foreach agency). .- 0 m . ..      fg    (notion only required for regiiest to change a,
                  AR Ee              te aye MM SE OE                   te Bee                      EL          development approval)   31h

      SDRLSIE dre feacons or    sttcation for theyequest (any            ok eB etirte                    ee         ee ee                                :
       RTL     RS NE FNRI                RS SE EET TEN Sa, aca ae ieaes ed                       ee ere te                  ieee te ae
        41. What are the details of the requested change and the reasons or justification for the change? Use a different row for each change if more    "
            than one.    ‘                                                                              .                ml,                               ow
                © Dats Of fequested change (includiig ext@nsion ofthe period i relevang. |*..Mes* Reasons or justification for the requested change" es]
                                              Hacthed                           |               As       Attéihed.                                     -
                             As           Atfeched                                                  AS     AREA,
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       Mandatory /attachm ents aid:information.syagisiedat 2g ES                      een               TSE OaeDeag                      a             hE
        42. What are the mandatory attachments and supporting information accompanying this application?        .                                          .
                 isos dots Description of attachment.or informations.“ << |: ' -Title.and ‘date (if eppiicabye)   Method of delivery to assessment
                 “(e.g fotice to Concurréiice /building referral agenciés, owner's ‘|. vt (e.g. James Street Traffic Report)” . manager.
                 "#3 consent;résource owner's agreement, drawings, reports) |"                                                     ree
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                     hé ter                            ;                       13 / 4/04                         Dehvery          AusRs7.

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          Advice for completing Form 2
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