06/1168 - Change a Development Approval [As Published] · 132006.1168.02

LOH

 

Table C—premises coordinates (appropriate for development in remote areas, over part of a lot or in water e.g. channel
dredging in Moreton Bay)

 

Coordinates

(note: place each set of coordinates in a separate row) “| reference area (if applicable)

Zone Datum Local government

 

Easting

Northing

Latitude Longitude

 

 

 

| GDA94
[] weseg
| Other

 

 

 

 

 

 

5. Details of the proposed change

 

 

Set ATAcHED Screpove A

 

 

 

6. ls owner's consent required for this request? (refer to notes at the end of this form for more information)

 

 

[] No

xX Yes—complete either table D or table E as applicable

 

Table D

 

Name of owner of the land

Sorsninwe COAST Coonciy

 

|, the above-mentioned owner of the land, consent to the making of this request.

 

Signature of owner of the land

IER Cea

 

Date

| Mas 2ZoVI9

 

 

Table E

 

Name of owner of the land

 

 

 

C] The owner’s written consent is attached

 

 

 

Request to change an existing approval template
Version 1.1 March 2010