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

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:....          ..................................I...                              ....................^`?'. iv `1

Lot No ...............................                Plan No.....         .....l...........

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 OWNER//SEAS PER DEPT. NATURAL RESOURCES RECORDS

Name:...D...                .^!1^....            ..........                    Name:..?

Signature:...........          ..   ................Registered Owner           Si !       :....                  ..............Registered Owner

Postal Address:.. ?!.O'. g"!f.^.......N^..                                            In 4
                                                                                      lot-&
                                                                                                  ......



BUILDER / APPLICANT DETAILS:

Name: ..................q* ..... -.1                          ................ Signature:..............................................

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




                      NOTE: PLEASE USE BLOCK LETTERS WHEN COMPLETING THIS FORM