Pre-Request Response Application 132001.210310.1

    3. Nature of proposed change/s (please tick ALL applicable categories)

    To change the development approval issued by:                   To change the conditions issued by;
    ~ Planning & Environment Court                                  Ill" Planning & Environment Court
    o    Minister                                                   o   Council (as a Concurrence agency)

    o   Other entity   -

                           please specify:                          o   Minister

                                                                    o   Concurrence Agency          -

                                                                                                        please specify:
                                                                    o   Other entity     -

                                                                                             please specify:
    Please attach documentation outlining the detail of and the reasons and justification for the requested change/so




,


    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 the Sunshine Coast Regional Council. Should any of the details given in relation to this application be
    changed in the future, the      cant shall advise the Sunshine Coast Regional Council in writing prior to any such change
    being implemented.
    Signature                                                                 .....                  Date    ]_~.~.12.    .




    Application no.        Amount paid       Date paid         Receipt no.            Initial               Date stamp



    Receiving Officer




                    Customer service centres: 8.30 am to 4.30 pm Monday to Friday (excludes public holidays).

                             or money order to be made   payable to: Sunshine Coast Regional Council.
                                               o Money order              0Mastercard                          0Visa

                    Card number                                           Expiry date                          Amount $ ((,’2..4-’00

                    Name on card                                          Signature of cardholder
                    Phone                                                 Is a receipt required?                           o No

    2 of 2   2011/12 Regional Strategy and Planning Pre-Request Response Application                             FM400/2-14/07/2011