MCU11/0080 Development Application part 1 of 2 Application forms 14 Stevens St SUNSHINE BEACH

14/04/2011              09:45             800 L19 EXECUTIVE 4 054438816                                                                         NO.438   0001
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          To Suncoast Building Approvals
          Phone: 07 5443 7288
          Facsimile 07 5443 8816
          e-mail- [email protected]
          PO Box 1054
          MAROOCHYDORE QLD 4558



                   OWNERS CONSENT TO LODGING DEVELOPMENT
                             APPLICATION FORMS
          PROPERTY DESCRIPTION:

          Site Address:.. 1.      ... S v.E
                                                      j\j .S ..S      ,.... SU. N S                      ..^.L       .c....
          Lot No.......... .... . ................            Plan No.............................


          To Whom It May Concern

          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 receive a permit to build on the said
          property and have signed below.

          It is 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 submission for and on our behalf in order to obtain development
          approvals.

          REGISTERED OWNERS AS PER DEFT. NATURAL RESOURCES RECORDS

          Name:.          "..........                V R'.^ .......                   Name: .............

          Signature:... . ........................... Registered Owner                 Signature:........ ..........................Registered
          Owner

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                                                                                                                        !        N S ^• / i 22^^
          Postal Address:.... P B e_.... X20 FL C7 ^'/ ^2- ^= SZ


          BUILDER / APPLICANT DETAILS:

          Name:........                                                        ...... Signature: ............................................


          Postal Address: .. .........................




                                 NOTE: PLEASE USE BLOCK LETTERS WHEN COMPLETING THIS FORM