07/1586 - Change to Development Approval [As Published] · 132007.1586.02

 

INTEGRATED PLANNING ACT 1997
3(b} CanJthe address be further described by shop/tenancy number or storey/level?

(Os Yes- Complete Table C

No
Table C

 

Shopftenancy number

Storey/level

 

1.

 

 

 

 

 

Form 2, Version 4.1, 3 March 2008

4, Can the premises best be identified by coordinates (e.g. for development propased in waters, of on a site within a large rural fol)?

 

 

 

No LC Yes - Complete Table D
Table D
Coordinates 2
. na ‘one Local government area
_ (Note: place ach set of coordinates ina separate row) _ Reference Datum {Hf applicable}
Easting Northing Latitude Longitude
1, (J coass C] wese4

 

 

 

 

 

 

J Other

 

 

5. Whatis the total area that makes up the premises (ie. the area covered by the application)?

 

Area of land above high water mark/outside watercourse

Area in a water body or watercourse

 

 

 

| m2 oO hectares (Tick applicable unit)

 

NA.

 

Om

LD hectares (Tick applicable unit)

 

Owner's consent and resource owner’s agreement

6. _ Is the person making the request the owner of the land to which the approval attaches?

 

 

 

 

 

O Yes [No — Complete Table E - provide details for each owner on a separate row, or on an attachment to this form if applicable. Note: Advice
provided at the end of this form details when owner's consent is not required.
Table E Details of the premises owned " * Date consent
Owner's namels and postal address (street address or Jot on plan description) Signature was obtained
1. THe 9ZOMG . .
ANS HELENS T2IReAS Nous AYILLE om r3/ohy
C Noosa carerees)

 

 

 

7. If an application for the existing approval were being made now (i.e. at the time of making this request), would evidence be required to
support the application because it involved taking or interfering with a State-owried resource prescribed by schedule 10 of the
Integrated Planning Regulation 1998 (IP Reg) or any other regutation

OO Yes- Complete Table F and submit, with the application, written agreement to the request.

(1 No

 

Table F Nature of State-owned resource

Relevant State Government Department

Date written agreement of the chief
executive was obtained

 

 

 

 

 

 

Nature of the request

8. Whatis the nature of the request for change? (Tick the applicable boxes)
C) An extension of the period before an approval lapses (under IPA, section 3.5.22)
to change the development approval other than a change of condition (under IPA, section 3.5.24}
(1 Tochange or cancel a condition of approval (under IPA, section 3.5.33) - Go to Q11
C1 Tochange conditions of a rezoning approval given under the Local Government (Planning and Environment) Act 1990 (under IPA,

section 6.1.35.

9. Were one or more concurrence agencies involved in the approval?

A) - Go to O12

* Owners signature can not be provided on the form if you intend to submit the application electronically. Owner's consent must be provided to the assessment manager on
an attachment containing appropriate written documentation of the owner's consent, If the owner is a company the company must sign as owner. $127 of the
Corporations Act 2001 {Cwealth) details how a company may execute a document.

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