Change to Existing Approval - Height Variation to Existing Dwelling - MCU11/0053.01

~~so~~,:,"~s_c’;~~~~_r..:qUlre~              for   thi~ .~~~catl~~_(refer to n;;~’;;’t~~.i!:;ct:’lf this form for nlO~e information)                       ]
o No
k8] Yes c;omrlete either tal)le 0,tallle E or table F as applicable
           -




Table 0(note: do ’101 comptete this table if lodging the application
                                                                                   on-line lIsing Smart eDA)



                                                                                                                   /}-~;::r--
                                                                                                   -




 Name of ownerls of the land                 ~~~AWiE                        a..      1<DL
                                                                                  -l!!
                                                                           the           oi this application.
 INve, the atJUve-lllentloned ownerls of the land, consent to
                                                                                 jklng
 ""~’""O,~oo"..,..,,"C                                                                                                j~
                                             [iY.      ~~.R~
                                                        _:_~F=---~~~
                                                                                                                                                      ---




 ::::~-
 Name of owneris of the land                 L_            .___...




                                                                                              to the <’lssessment manager
  o The owner’s written consent is attached or will be provided separately
                                                                                         _.__._----------------------_..-
 ----_._,----_.__.__._-~-_._~-----_._-_.-


 Table F



  Name of ownerls of Ihe land


        By making this application. I, the applicant. declare that the owner
  o the application.
                                                                                          has given written consent to the makin\) of
                                                                                                                                                             J
                                                                                                                                                             .




                                                                                              ihvolves state land, or tal<ing quarry
 [!looesthe application
 Ill_’_aterials. Refer
 ."
                        involve state resource? (e.g. the application
                         to
                                               a

                  the notes at the end of this form for information)
                                                           .
                                                                       more
                                                                                              --_.".__._--------~----
                                                                                                                                                            J
  k8]No                                     DYes complete table G
                                                       -




 l~o. Identify   If any of the       f~lowing ap~ly to the premises (tick applicabte bOl<1e.;j-----. ---J
                                                                                              lake, canalj       complete table H
          adjacent to a water body. watercourse or aquifer (e.g creek, river,
                                                                                                             -




  o
               strategic port land under the Trans!’ort Infrastruelure
                                                                                  Act "1994   .

                                                                                               complete tallle I
  o       on



  []      in a tidal water area        -
                                           complete table .J


  11.
        ~:~e~~:~~.~ny existing
                                        easements on the premises? (e.g. f           r vehicular access,
                                                                                                                 el:triGi.t~_:_~~~:~I::~_J
                              ensure the type, localion and dlrnenslon
                                                                           of each easement is included in the plans slIl)milled
  C8l No 0Yes            .’




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                                                                                                                  ’;’’’;i;fi’’:i.’!J,;-,: !        IDAS ’01111 t
                                                                                                                      V (~kJll 1 {I 18 [!(~(:&’TJf~r ,")I/r;~!