Attachment D- State Extension to Approval Form

 2 years – 25 March 2023



PART 4 – FOR OFFICE USE ONLY
 Date received:                          Reference number(s):




The Planning Act 2016, the Planning Regulation 2017 and the DA Rules are administered by the Department of
Infrastructure, Local Government and Planning. This template (or the assessment manager’s form) and any additional
materials supporting this extension application must be sent to the assessment manager.




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                                                                                                     Applicant template 5.0
                                                                                                   Version 1.0—3 July 2017