51995.1871.02 (TPC 2888Additional Information

3.`Nature of tequest (please.':tlick AI:I.: applicable:categories}
Cf To change the development                17 To change the development                   0 To extend the relevant period
    approval                                     conditions                                    before lapsing
Please attach documentation outlining the detail of and the reasons and justification for the requested change or
extension.




5. Concurrance Agencies
Was there one or more concurrence agencies Involved In the original approval?                  t3'No            _
                                                                                               q Yes-provide details below
Note - Under s372 of the Sustainable Planning Act 2009 the person making the request Is required to give a copy of this request to all
concurrence agencies,




6. Pre-request response notice
Has a pre-request response been given by a relevant entity (e.g. a concurrence agency) for this request?
C2'No                                                   q Yes
If yes, please attach a copy of the notice.


7. Owner's consent
Is the owner's consent required for this request?
                                                                   I   'es-- complete either Table A or Table B below
Note - If more than one owner of the land all owners' details are required



                                                                         Date
                       3r^n t     ^^                                                            Oa /•' /I /
                       ^h^ /,   .Thf-
                                  ->-                                    'fig,        wnec's cons t provided on form
 Me, the above-mentio  ns of the land, consent
 to the making of this request.                                          Owner's name/s

 Signature/s                                                             0 The owner's wri ttan consent is attached.




 2 of 4   2011112 Regional Strategy and Planning Request to Change Existing Approval and/or Extension to Relevant Period FM401


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

[f To change the development OQ To change the development 0 To extend the relevant period
approval conditions before lapsing

Please attach documentation outlining the detall of and the reasons and Justification for the requested change or
extension.

   

 

4. Location of the premises
Unit No.

 

 

 

 

 

 

5, Concurrance Agencies

Was there one or more concurrence agencies Involved in the original approval? No =
—_ oO Yes-provide details below

Note ~ Under s372 of the Sustainable Planning Act 2009 the person making the request Is required to give a copy of this request to all
concurrence agencles.

 

 

 

 

 

6. Pre-request response notice
Has a pre-request response been given by a relevant entity (e.g. a concurrence agency) for this request?

[aNo CO lo Yes

If If yes, please attach a copy of the notice. —

 

 

7. Owner’s consent
Is the owner's consent required for this request? O No

Pa WYes-— complete either Table A or Table B below
Note — If more than one owner of the land all owners’ detalls are require

 

 

 

 

 

 

 

REC NK CCRC

Grent Flithany. On hic)
Ar |, 2 Tshr Gexcan

   

Date Qalii/fa2crs

iru PSM a eect if iCTine

    
 

Owner's name/s

 

   
   

 

 

 

 

 

 

We, the above-m entioned owner/s of the land, consent car - Nie)
to the making of this request. Owner’s name/s

PK 7 PAilig Fehon as |
Signature/s ath, wi a OThe owner's written congent Is attached. e)

 

 

 

 

 

20f4 2014/12 Reglonal Strategy and Planning Request to Change Existing Approval and/or Extension to Relevant Period FM401