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Owner Consent Signed form
on the premises described above for:
Request for a ‘minor change’ to development approval MCU16/0079.02 to provide for two (2) storage
areas.
Company seal {if used]
Company Name and ACN: .o...cccccesececsseseeserreeeaeprursvapeenneneces nasneneee nae nterernanea tase ces nasser cee Peer eae ne
Date
[Delete the above where company owner's consent must come from both director and director/secretary.]
Company Name and BOR FeuypaTi® Nove ASL-& CyTenins Memvtenc:dieb “+9 €- bes
NWN) 26647 7/ZSES
[Delete the above where there is a sole director/secretary for the company giving the owner's consent.]
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Applicant template 11.0
Version 1,0—3 July 2017
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