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Owners Consent
Individual owner’s consent for making a development application under the Planning Act 2016 We, Ashley Neil and Puk Bjorn SCIVYER Ashley Nee! gud PE 5 ory SG / y Cy as owner of the premises identified as follows: 497 Black Mountain Road, Black Mountain (Lot 7 RP 838780) [/nsert street address, lot on plan description or coordinates of the premises the subject of the application.] consent to the making of a development application under the Planning Act 2016 by: Project Urban [/nsert name of applicant.] on the premises described above for: Material change of use — dwelling house (secondary dwelling) [/nsert details of the proposed development, e.g. material change of use for four storey apartment building. | hi Vs bo} [signature of ownesr and la/ 2 7. / date signed] Applicant template 10.0 Version 1.0—3 July 2017
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