08/0256 - Change to Development Approval [As Published] · 142008.256.02

 

INTEGRATED PLANNING ACT 1997
3(b) Can the address be further described by shop/tenancy number or storey/level?

 

 

No (0 Yes- Complete Table C
Table C Shop/tenancy number Storey/level
1.

 

 

 

 

 

Form 2, Version 4.1, 3 March 2008

4. Can the premises best be identified by coordinates (e.g. for development proposed in waters, or on a site within a large rural lof?

 

 

No (1 Yes - Complete Table D
Table D
Coordinates
(Note: place each set of coordinates in a separate row) Zone Datum Local goverment area
: — - - Reference (if applicable)
Easting Northing Latitude Longitude

 

 

 

 

 

 

 

Ci cpao4 (J wese4

(7 Other

 

 

5. Whats the total area that makes up the premises (Le. the area covered by the application?

 

Area of land above high water mark/outside watercourse

Area in a water body or watercourse

 

7:

 

 

oe 2 Cm [ifectares (Tick applicable unit) a

 

 

Cm

Do hectares (rick applicable unit)

 

Owner's consent and resource owner's agreement

 

 

 

6. 1s the person making the request the owner of the land to which the approval attaches?
Yes (1 No - Complete Table E - provide details for each owner on a separate row, of on an attachment to this form it applicable. Note: Advice
provided at the end of this form details when owner's consent is not required.
Table E Detaits of the premi
premises owned * Date consent
Owner's name/s and postal address (Greet address or fot on plan description) Signature’ was obtained
1,

 

 

 

 

 

 

7. {fan application for the existing approval were being made 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
wn Planning Regulation 1998 (IP Reg) or any other regulation

 

 

 

 

 

 

 

No C1 Yes - Complete Table F and submit, with the application, writen agreement to the request.
Table F Nature of State-owned resource Relevant State Government Department Date written 3 igreement of the chief
executive was obtained
1,
Nature of the request

 

8. What is the nature of the request for change? (Tick the applicable box/es)
(1 Anextension of the period before an approval lapses (under IPA, section 3.5.22)
(1 Tochange the development approval other than a change of condition (under IPA, section 3.5.24)
W To change or cancel a condition of approval (under IPA, section 3.5.33) - Go fo Q77

(1 Tochange conditions of a rezoning approval given under the Loca/ Government (Planning and Environment) Act 1990 (under IPA,
section 6.1.35A) - 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 provided to the assessment manager on
an attachment containing appropriate written documentation of the owner's consent. If the owner is a company the company must sign as owner. 5127 of the
Corporations Act 2001 (Cwealth) details how a company may execute a document.

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