Noosa Council - Request to Change Form Signed · 132004.240098.6

 

4. Location of the premises |

Unit No. StreetNo 21 Street Elizabeth Street
Suburb Noosaville State QLD Postcode 4566

Fans ene
0 : SP188227

 

5. Concurrence Agencies

Was there one or more concurrence agencies involved in the original approval? No
O Yes-provide details below

Note — Under s372 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 : : : ate copy given

 

6. Pre-request response notice

Has a pre-request response been given by a relevant entity (e.g. a concurrence agency) for this request?
KI No O Yes
If yes, please attach a copy of the notice.

 

 

7. Owner’s consent
Is the owner's consent required for this request? ONo

{ Yes— complete either Table A or Table B below
Note — If more than one owner of the land all owners’ details are required

Blo) (ewe ia} rei Pace! eit : Bir} J owner's consent provided onform =

On The Terrace’ Body Corporate Owner's name/s

 

Owner's name/s

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

pain
: Z Ze Lo - Cd Brig
Signature/s Ws: .
Cee Loreup Tree PIE rIGZR

oe 74/9 JE

 

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