Extension Request Jun 2015 · REC10/2072

E To change the developmenl                   E To change the develop$ent                     To extend the relevant period
  approval                                         condilions                                 before lapsing
Please attach documentation outlining the dotailotand the rcasons and juitlficalion for the requested chango or
extension.



Unil No.                                                    S'neet d /A^             5r
Subu*)                                                                       Slate   0^a                Postcode         r/s
                    /i T- / d?", sr''S ,.s z                    /s'
   ( /a,rzzr'<'t Y lrr 7zv a,. i/ 2a t 56 9,)



Was ther6 one or more concunence ageocies involved in the original approval?
                                                                                             O Yes.provide details bolow
Noi .- Under s372 of th6 Suslainable Planning Ad 2AO9lh6 person maklng th€ reqre"t is ,"qrir"a ro g,r" u *pV ot rt i" ,uqru"r r" all
concurrence agencies.




         pre-request response be6n given by a relevanl entity (e.9. a concurence agency)for this request?
#rl                                                             E Yes
lf ye3, please atiach a copy ol the noti;e.



ls the owner's consent required tor this request?                  o*ls-
                                                                             conptete eitner rabte A oriabte B below
Note - lf more ihan one owrer ot lhe land all owners' details are requir€d




owner,s name/s       {ttt /3 l.z tzruz-r                                owner s name/s      7 /Ll/3 /t/ /A,Ya
l/we, lhe above-me;lioneO ownerA of tne tanJ, consent                    E The owner's written consent is attacneJ
to the making of this requesl.

Signaiure/s


Date