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0014C22C.001

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mt ie
           INTEGRATED PLANNING ACT 1997                                                                                             Part A, Version 2.4, 29 May 2006
                                                    Notification of Engagement of Private Certifier (Optional format)
             Tow                                                   Council. | have been engaged as the private certifier for the building work referred to in this application.
             Date ofengagement    /   /   AccreditationNumber__oo                   Names                               Signature:

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