Da Consent Form

iF (Wau ce@ . eek S lea & Doreen Ss oe “~ [insert name in full]

as owner of premises identified as follows

 

22 Ann Street, Noosaville described as Lot 8 on RP81559

[insert 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 Sustainable Planning Act 2009 by

Noosa Town Planning [insert name of applicant]

 

on the premises described above for the purposes of:

Material Change of Use — Multiple Housing Type 2 (Duplex)

 

[insert details the proposed development, e.g. material change of use for three storey apartment building]

Meme pe 9’ Rommann {signature of owner]

signed on the nd day of 6 aeee 20 ca