Change to DA request · 132002.220527.1

 

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

hk To change the development O To change the development O 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. @ cee TINTON

 

 
  

 

4. Location of the premises

 

Unit No. [StreetNo i"] - [Street weBbh RN
Suburb ZA SUG POAC State UL) Postcode “S677

Plan type & plan no.

 

 

 

 

 

 

 

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

be | el Yes-provide details below -

Note — Under 372 of the Sustainable Planning Act 2009 the person making the request is required to give a copy of this request to all
concurrence agencies.

Concurrence Agency Dateicopy given

 

 

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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?

wo |D Yes oe

If yes, please attach a copy of the notice.

 

 

 

 

RON Tite ae Mere XeT AL

Is the owner's consent required for this request? ONo
wWYes— 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 providedion form Table B= owner's consent provided on form
WES W CHinh7 6

Owner’s name/s Owner's name/s

 

 

 

 

 

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IMWe, the above-mentioned owner/s of the land, consent The owner's written consent is attached.
to the making of this request.

 

 

 

Signature/s

 

Date

 

 

 

 

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