Request to Extend Relevant Period - 152006.1999.01

3. Nature of request (please tick ALL applicable             categories)
o    To change the development                    o    To change the development                 Ii2I To extend the relevant period
     approval                                          conditions                                     before lapsing
Please attach documentation           outlining   the detail of and the reasons and justification          for the requested    change or
extension.


4. Location   of the premises
Untt No.                          Street No 191                Street Hollett Road
Suburb Noosaville                                                                 State QLD


53                                SP163571




5. Concurrence     Agencies
Was there one or more concurrence agencies involved in the original approval?                        ONo

                                                                                                     Ii2I Yes-provide details below
Note - Under s372 of the Suslainable Planning Acl 2009 the person making the request is required to give a copy of this request to all
concurrence agencies.
Concurrence      Agency                                                                             ,Date copy given
SARA - Department         of Natural Resources         and Mines                                     24 AJlril2017
SARA - Evironmental        Protection     Agency                                                     24 April 2017




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

Ii2I No                                                                     10 Yes
If yes, please attach a copy of the notice.


7. Owner's    consent
Is the owner's consent required for this request?                     o No
                                                                      Ii2I Yes- complete either Table A or Table B below
Note - If more than one owner of the land all owners' details are required


Table A - owner's       consent     provided   on form

Owner's namel
                                                      , q"
I/We, the above-mentioned ownerls of the land, consent                                              John Stuart Hofmann
to the making of this request.                                                  Owner's namels
                                                                                                    Kathleen   Mary Hofmann

Signaturels                                                                     Ii2I The owner's written consent is attached.



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