23120 DA Development Application part 1 of 2 Application Letter and Request to Change form 132002.220611.3

1;
     Sunshine Coast                           2011/12 Regional Strategy and Planning
     Council Request to Change Existing Approval and/or Extension to Relevant Period

                                                                                                      Sustainable Planning Act 2009

 ALL questions MUST be completed unless the form indicates otherwise.
 This form must be submitted to Council accompanied by the applicable fee.
 Attach extra pages if there is insufficient space on the form.
 If Council was the Assessment Manager for the existing approval, and the approval was issued by the Court, then:
 (a) a request to change the development approval and/or conditions is made to the Court; and
 (b) a request to extend the relevant period for the approval is made to Council.
 All terms used on the form have the meaning given in the Sustainable Planning Act 2009 or the Sustainable Planning Regulation
 2009.


1. Details of person making the request
Full name - individual or company G$m) SET tEAS                             caE P7`/
Contact Name - for company           C1A^y         G0       f2.`/
Postal address       PO     60X         ( 9 23                      _
Suburb  Q005A 4'1S                                                            State Q L^                    Postcode   45,67
Business phone (6)) S4.$ OI$G A/H phone                                                       Mobile 01+ 17     9co
                                                                                                                  ' -7 1 96
Email address       Gt q r^ 9od Fre                  c4pc b ouvafd. c -au                     Fax


2. Details of existing approval
Typ      of approval (please tick ALL applicable categories)            Whi h entity issued approval?
t ( Development Permit                                                  If' Sunshine Coast Council
q     Preliminary Approval                                              q   Other entity - please specify
q     Compliance Permit
q     Material Change of Use
q     Reconfiguring a Lot
q     Operational Works
q     Building Works
q     Plumbing or Drainage Works
q     Compliance Certificate
q     Environmentally Relevant Activity
Application number/council reference             Zo 0 21 22OG I 1           (2-312-0 /^A)               Date issued 10 (06 (I O
Is the approval for a mobile and temporary ERA?                                     fa   No             q    Yes - complete below
Insert the name of each local government area in which the mobile and temporary ERA is proposed to operate/operating




Privacy
Council will use any personal information provided for the intended purpose only and for remaining in contact with you. Council is
authorised to collect this information in accordance with the Local Government Act 2009 and other Local Government Acts. Your
personal information is only accessed by persons authorised to do so. Your personal information is dealt with in accordance with
council's privacy policy.


www.sunshlnecoastgld.gov.su I ,n sunshmecoast.gld.gov.au I T 07 5475 7272 F 07 5475 7277
Lodced Bag 72 Sunshine Coast Mail Centre Old 4560 ^ ABN 37 878 973 913

Caloundra obits 1 Ornrah Avenue Caloundra Old 4551     Maroochydors office 11-13 Ocean Skeet Mamodiydore Old 4558
Nwnbour office Cnr Currie and Bury Streets Nambour Old 4580 1  Tewanttn office 9 Pelican Street Tewantin Qld 4585


1 of 4      2011112 Regional Strategy and Planning Request to Change Existing Approval and/or Extension to Relevant Period FM401



                                                                                                /3Q O oa . aa06 l'( .