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

3. Nature of request (please tick ALL applicable categories)
V.   To change the development                M F To change the development                   U.     To extend the relevant period
     approval                                     conditions                                         before lapsing
Please attach documentation outlining the detail of and the reasons and justification for the requested change or
extension.



4. Location of the premises
Unit No.                 Street No ILf.                     Street        -_4&^j ay
                                                                        se=                   C1 O SE
Suburb     NOOSA HEADS                                                       State   52LZ^)                  Postcode 4S6 7
Lot no.                       Plan type & plan no.
                               5P r 9s4a7 j




5. Concurrance Agencies
Was there one or more concurrence agencies involved in the original approval?
                                                                                                   q 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                                                                                 I Date copy given




6. Pre-request response notice
Ha            equest response been                  elevant entity (e.g. a concurrence agency) for this request?
la N o                                                          q Yes
If yes, please attach a copy of the notice.


7. Owner's consent
Is the owner's consent required for this request?                    l 'No
                                                                     q Yes- complete either Table A or Table B below
Note - If more than one owner of the land all owners' details are required


Table A - owner's consent provided on form
                     C60J T7t?e-^ 0O'C P7zl C.^
                                                                         Date                      o-7   /i o /1i
Owner's name/s
                                                                         Table A - owner's consent provided on form
I/We, the above-mentioned owner/s of the land, consent                                               P Jz 7A C J Fo t& i0724 (J7
to the making of this request.                                           Owner's name/s

Signature/s                                                              ff'T
                                                                            'he owner's written consent is attached.




2 of 4    2011/12 Regional Strategy and Planning Request to Change Existing Approval and/or Extension to Relevant Period FM401