07/1728 - Change to Development Approval - Boundary Setback [As Published] · 132007.1728.02

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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INTEGRATED PLANNING ACT 1997 Form 2, Version 4.1, 3 March 2008
3(b) Can the address be further described by shop/tenancy number or storey/level?
(10 No . [1] Yes- Complete Table C
Table C Shop/tenancy number __ Storey/level
1.
4. Can the premises best be identified by coordinates (e.g. for development proposed in waters, or on a site within a large rural ot)?
(1 No ] Yes ~ Complete Table D
Table D
Coordinates
. Se i Zone Local government area
(Nole: place ach sot of coordinates ina ‘Separate row} Reference Datum (if applicable)
Easting Northing Latitude Longitude
1. . Cicoasa C] wese4
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other
5. Whatis the total area that makes up the premises (i.e. the area covered by the application)?
Area of land above high water mark/outside watercourse Area in a water body or watercourse
G27 BR m2 (_] hectares (Tick applicable unit) (Om — Dyhectares (Tick appticable unit)
ean ° as Lo Loo: wit. . a ° e . “aH
Owner’s consent and resource owner's agreement
6. Is the’person making the request the owner of the land to which the approval attaches?
Yes. A No - Complete Table E - provide details for each ‘owner on a Separate row, of on an altachment to this form if applicable, Note: Advice
provided at the end of this form details when owner's consent is not required.
Table E Details of the premises owned : * Date consent
Owner's name/s and postal address (street adcress or ot on plen description) Signature was obtained x
1. | PAWO SNOVMOEWM L407 £17 WIe7 /2/8/o8"
: EP /O2579 THE \
Pe baZenh7 Be- A -
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7. If an application for the existing approval were bon ing 226 now (i.e. at the time of making this request), would evidence be required to
support the application because it involved taking or interfering with a State-owned resource prescribed by schedule 10 of the
integrated Planning Regulation 1998 (IP Reg) or any other regulation

Bd No [1 Yes - Complete Table F and submit, with the application, written agreemént to the request.

 

Date written agreement of the chief

Table F
Nature of State-owned resource Relevant State Goverment Department executive was obtained

 

 

 

 

 

 

 

Nature of the request

 

8. What is the nature of the request for change? (Tick the applicable box/es)
(= Anexiension of the period before an approval lapses (under PA, section 3.5.22)
ff To change the development approval other than a change of condition (under (PA, section 3.5.24)
. x. To change or cancel a condition of approval (under IPA, section 3.5.33) - Go to Q11

(To change conditions of a rezoning approval given under the Local Government (Planning and Environment) Act 1990 (under IPA,
section 6.1.35) - Go to Q12 .

9. Were one or more concurrence agencies .involved in the approval?

* Owner's signature can not be provided on the form if you intend to submit the application electronically. Owner's consent must be provid to the assessment manager on
an attachment containing appropriate written documentation of the owner's consent. {f the owner is a company the company must sign as owner, $127 of the
Corporations Act 2001 (Cwealth) de details how a company may execute a document.

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