Application Form · 131998.982104

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3. Nature of request (please tick ALL applicable categories)

t

| To change the development i To change the development O To extend the relevant period
_approval_ conditions _before fore lapsing

'Please attach documentation outli ng the detail of and the reasons and justification for the requested change or ,
jextension. = Se¢ S84_ FED otrss ev bec 20/6 - j

  
  

4. Location of the edges,
—___{StreetNo 52. [Street Senview |
SUNS INE hence ‘State ep ‘Postcode 456
/Plan type & plan no.

@L | RF €@G/0

   
  
 

    

 

   

| Was there one or more concurrence agencies ee in the original se ‘or No
den T fe re, 2G a2 670 Yes
| JCA ts ace OSGEEX Zs oO. Yes provide details below

' Note — Under s372 of the ee ere ite Cat 2009 eve person making the ear, is required to give a copy of this request to all
, concurrence agencies.

Concurrence Agency al? copy given

 

ry Has a pre-request re Tesponse been given t by a relevant entity (e. g. a concurrence > agency) for ‘this request? —

 

 

vee Tle) eee

| Is the owner’s consent required for this request? |

| a Ye S— complete ‘either Table Aor Table B below
‘Note — lf more than one owner of the land all Owners’ details are required

Wl A — owner's consent provided on form brant B — owner’s consent provided on form

 

| Owner's name/s | ia “Owner's name/s

Ln ae ee nn as |
\IWe, the above-mentioned owner/s of the land, consent io The owner's written consent i is attached.
to the making of this request. — i a

‘Sinatra ET

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, NOTES: For question 7

i
! Under section 371 of the Sustainable Planning Act 2009, if the person making the request is not the owner of the land to which the
! approval relates, the request must be accompanied by the owner's consent.

» However, owner's consent is not required if the approval:

' - relates to land the was acquisition land to which section 263(2)(d) of the Sustainable Planning Act 2009 applied when the
| application for the approval was made; or

i is for building work or operational work for the supply of community infrastructure on land designated for the community
: infrastructure; or

' _ the consent of the owner would not be required under section 263(1) of the Sustainable Planning Act 2009 if a development
application were made for the requested change.

Also, owner's consent is not required if the Assessment Manager is satisfied that:

- the number of owners of the land make it impractical to obtain owners’ consent, and the requested change does not materially
affect the owners’ land; or

; - having regard to the nature of the proposed change, the owner has unreasonably withheld consent and the requested change
does not materially affect the owner's land.

     

F
; Nature of State owned resource:

i i Nature of Evidence required:

 

  

vidence of allocation of / entitlement to, the re resource Qo (Evidence the ch chief executive has agreed {tot the , request

[oe ee rin en et Secreta

| Attach a copy of the evidence required above
| NOTES: For question 8

| Section 370(3) and (4) of the Sustainable Planning Act 2009 requires that if an application for the development approval were made at
_ the time of making this request and evidence under section 264(1) of the Sustainable Planning Act 2009 would be required to support
ithe application, this request must be accompanied by the written agreement of the chief executive from whom evidence would be
/ required under section 264(1).

Section 264 of the Sustainable Planning Act 2009 provides that if a development involves a State resource, a regulation may require
| the application to be supported by certain evidence prescribed under regulation. Schedule 14 of the Sustainable Planning Regulation
| 2009 prescribes the State resources for which evidence is required to be given, and the evidence required, to support the application.

9. Declaration of applican|

 

|WWe, the applicant, declare that the above information is correct in all respects, at the time of lodgement of this
| application with Council. Should any of the details given in relation to this application be changed in the future, the
| applicant shall advise Council in writing prior to to any such change being implemented. —

Signature/s per wetland -

 

 

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

Receiving Officer

es options

[In person 9 Pelican Street, Tewantin: 8.30 am to 4. 30 pm Monday 1 to Friday (excludes public holidays).

 

  

 

| ‘By mail | Cheque or money order ‘to be made payable to Noosa Council.

| [Cheque Money order OMastercard Visa

| |Card number Co _ Expiry date |Amount $
[Nameoncard | Signature of ‘cardholder | |

| | Phone oe ; 7 oo __ lisa receipt required? “Yes ONo |}

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