09/1530 - MCU - Detached House [As Published] · 132009.1530

To Suncoast Building Approvals

Phone: 07 5443 7288
Facsimile: 07 5443 8816
Email: [email protected]
Mail: PO Box 1054

MAROOCHYDORE QLD 4558

OWNERS CONSENT TO LODGING DEVELOPMENT

APPLICATION FORMS
YROPERTY DESCRIPTION:
Site Address: Lawnville Road, Black Mountain QLD 4563
Lot: 23
SP: 199350
‘To Whom It May Concem:

‘The registered owners of the above site consents to the applicant or the engaged private building certifier submitting any
development approvals including plumbing for the property as noted above in order to reccive a permit to build on the
said property and have signed below.

It {s also agreed by the owner to give authority for an agent from the engaged private certifier to lodge and sign any
council or state government forms necessary for submiasion for and on our behalf in order to obtain development
approvals,

REGISTERED OWNER/S AS PER DEPT. NATURAL RESOURCES RECORDS

Name: Henry Alexander Curran Name: Deidre Isabella Curran

Coy, <a

Signatures. rT eee eeecereveee Registered Owner Signature: TT er cceee eee ees Registered Owner

Ve

Postal Address:
41 Lakeside Drive
Peregian Springs QLD 4573

BUILDER / APPLICANT DETAILS:

  
 

Name: Ausmar Homes Pty Ltd SHQMAUUTE! oo. e coe GG herr tecrerceennenewerenesen ree teees
Postal Address: PO Box 418 Cooroy Qld 4563

NOTE; PLEASE USE BLOCK LETTERS WHEN COMPLETING THIS FORM