13967 Loa · OPW16/0237

#13967

TO WHOM IT MAY CONCERN

AUTHORITY TO LODGE MARINE BERTHING APPLICATIONS

As the registered owner/s of the ‘property described below, Wwe hereby authorise
Superior Jetties to lodge any applications associated with the required approvals for a
marine structure adjacent to the specified land and to make any required enquiries in

regard to such applications on my/our behalf.

Addressiof Property:
[o7_ POOSA_ PREAD]E pean y cranes ys \ MLE post code: KOE,

Lot Number: veeeeeee ceetenees Plan Number:..... Ce (057) peeeerneeeeesess

TTR Ree LEWGLLKG
Register ed Owners: .

NAME IN FULL SIGNATURE » DATE