5409SignedOwnersConsentForm

 Individual owner’s consent for making a development application under
 the Planning Act 2016



 We, Michelle Joy Tickner and William John Tickner




 as owners of the premises identified as follows:


 23 Little Creek Road, Cooroibah – Lot 3 on RP211638.




consent to the making of a development application under the Planning Act 2016 by:

 Max Watterson & Associates


on the premises described above for:

 Reconfiguration of a Lot – 1 Lot into 2 Lots.




                                                                                                 [signature of owner and
                                                                                                              date signed]




 The Planning Act 2016 is administered by the Department of Local Government, Infrastructure and Planning, Queensland
 Government.


                                                                                                         Applicant template 10.0
                                                                                                        Version 1.0—3 July 2017