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Pre Request Response Application form · 132006.268.03

Attached to the e-mail Pre-Request for Minor Change to MCU - 132006.268.03.

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                                                                                                   Pre-Request Response Application



                                                                                                                                   Planning Act 2016
ALL questions MUST be completed unless the form indicates otherwise.
This form must be submitted to Council accompanied by the applicable fee.
Attach extra pages if there is insufficient space on the form.
All terms used on the form have the meaning given in the Planning Act 2016 or the Planning Regulation 2017.

1. Details of person making the request
Full name – individual or company               Noosa Beverages Pty Ltd C/- ADAMS+SPARKES Town Planning
Contact Name – for company Michael Harries
Postal address PO Box 1000
Suburb BUDDINA                                                                        State QLD                          Postcode 4575
Business phone 5313 7705                            A/H phone                                           Mobile
Email address        [email protected]                                                                 Fax

2. Details of existing approval
Type of approval (please tick ALL applicable categories)                      Which entity issued approval?
    Development Permit                                                           Council
    Preliminary Approval                                                         Planning & Environment Court
    Material Change of Use                                                       Minister (under part 11, division 2)
    Reconfiguring a Lot                                                          Other entity – please specify
    Operational Works
    Building Works
    Plumbing or Drainage Works
    Environmentally Relevant Activity
Application number/council reference              Council: 2006/268 - P&E : 4884 of 2014                             Date issued 2006 and 2014
Is the approval for a mobile and temporary ERA?                                                   No                 Yes – complete below
Insert the name of each local government area in which the mobile and temporary ERA is proposed to operate/operating



3. Nature of proposed change/s (please tick ALL applicable categories)
To change the development approval issued by:                                 To change the conditions issued by;
    Planning & Environment Court                                                 Planning & Environment Court
    Minister                                                                     Council (as a Concurrence agency)
    Other entity – please specify:                                               Minister
                                                                                  Concurrence Agency – please specify:
                                                                                  Other entity – please specify:
Please attach documentation outlining the detail of and the reasons and justification for the requested change/s.




Privacy
Council will use any personal information provided for the intended purpose only and for remaining in contact with you. Council is authorised to collect
this information in accordance with the Local Government Act 2009 and other Local Government Acts. Your personal information is only accessed by
persons authorised to do so. Your personal information is dealt with in accordance with council’s privacy policy.


www.noosa.qld.gov.au                        [email protected]                       T 07 5329 6500
PO Box 141 Tewantin Qld 4565                                                            ABN 97 969 214 121

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4. Location of the premises
Unit No.                      Street No 314                Street Cooroy Mountain Road,
Suburb Cooroy                                                          State QLD                          Postcode
Lot no.                       Plan type & plan no.
Lot 2                          SP143409




5. Declaration of applicant
I/We, the applicant, declare that the above information is correct in all respects, at the time of lodgement of this
application with Council. Should any of the details given in relation to this application be changed in the future, the
applicant shall advise Council in writing prior to any such change being implemented.
Signature                                                                                            Date 12/10/2017


OFFICE USE ONLY
Application no.      Amount paid          Date paid            Receipt no.          Initial              Date stamp


Receiving Officer




Payment options

In person     9 Pelican Street, Tewantin: 8.30 am to 4.30 pm Monday to Friday (excludes public holidays).
By mail       Cheque or money order to be made payable to Noosa Council.
               Cheque                        Money order                   Mastercard                   Visa
              Card number                                                   Expiry date                   Amount $
              Name on card                                                  Signature of cardholder
              Phone                                                         Is a receipt required?          Yes          No
All payments made by credit card will incur a 0.50% surcharge (exempt of GST) to reflect the cost of fees charged for credit card
transactions.



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