Requesting info for lodging change to existing approval to release bond · 132003.221194.1

3. Nature of request (please tick ALL applicable categories)

[Od To change the development i To change the development ‘O To extend the relevant period
; approval i conditions 1..before lapsing a

Please 2 attach documentation outlining the detail of and the reasons ‘and justification | for the requested change or.
-extension. ;

erent mice AA Sia ae mana ESO Oo FA He a eer ae Aen eae ae meee eaten ne cme meee 1

4, Location of the premises

|StreetNo 245 [Street GYMPIE TCE
|State Brp

 

  

     

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5. Concurrence Agencies
i: Was there one or more concurrence agencies invalved in the original approval? | Mi No
| O Yes-provide details below

' Note ~ Under $372 of the Sustainable Planning Ac Act 2009 ‘the | person n making the re request i is required to give a copy oft this request to all ;
| concurrence agencies, :

 

  

 

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6. Pre-request response notice

_ Has a pre-request response been given by a relevant entity (e.g. a concurrence agency) for this request?

No

lfyes, please attach a copy of the notice.

| Is the owner's consent required for this request? be No :

/ _. joy Yes— complete either Table A or Table B below ~—
ner of the fand all | owners details are required

 

 

 

 
 

 

| Note — If more than one

  

   

    

|
|Ouners name/s rr oem cst sata amt sa es oral
tie, the above-mentioned owneris of the Ia land, ‘consent |
to the making of this request.

|
1 Signature/s

  

 

; Date :

 

 

 

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