Pre_Request_Response_Application

4. Location of the premises
Unit No.                   Street No 269             Street Gympie Terrace
Suburb Noosaville                                                  State QLD                  Postcode 4566
Lot no.                    Plan type & plan no.
0                          SP129587




5. Declaration of applicant
I/We, the applicant, declare that the above information is correct in all respects, at the time of lodgement of this
application with Council. Should any of the details given in relation to this application be changed in the future, the
applicant shall advise Council in writing prior to any such change being implemented.
Signature                                                                               Date 15/12/20


OFFICE USE ONLY
Application no.     Amount paid       Date paid         Receipt no.        Initial           Date stamp


Receiving Officer




Payment options

In Person    9 Pelican Street, Tewantin: 8.30 am to 4.30 pm Monday to Friday (excludes public holidays).
By Link      A payment link will be forward to you once your application has been lodged.
By mail      Cheque or money order to be made payable to Noosa Council.
              Cheque                                          Money order

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