Permissible change request

ae Request to Change Existing Approval and/or
e NOO COUNCIL Extension to Relevant Period

Sustainable Planning Act 2009

ALL questions MUST be completed unless the form indicates otherwise.
| This form must be submitted to Council accompanied by the applicable fee.
Attach extra pages if there is insufficient space on the form.
lf Council was the Assessment Manager for the existing approval, and the approval was issued by the Court, then: -
(a) a request to change the development approval and/or conditions is made to the Court; and
(b) a request to extend the relevant period for the approval is made to Council.

All terms used on the form have the meaning given in the Sustainable Planning Act 2009 or the Sustainable Planning Regulation
2009.

Full name — individuat or company Maat Cmae tick wy,
Contact Name —forcompany Sjrrorw +Helealerory
Postaladdress (0 (Zoe (erg

Suburb anascu, CE State by Postcode 2 <¢ +
Business phone 02 (G++ Joe; | A/H phone Mobile
Email address sip... Planikcousn Way. eran Fax

 

2. Details of existing approval

Type of approval (please tick ALL applicable categories) Which entity issued approval?

Development Permit O Council

Preliminary Approval Ol Other entity — please specify

Compliance Permit

Material Change of Use

Reconfiguring a Lot

Operational Works

Building Works

Plumbing or Drainage Works

Compliance Certificate

Environmentally Relevant Activity

Application number/council reference mW CJ | | OO 7A Date issued {« { 02] re
Is the approval for a mobile and temporary ERA? O No O Yes — complete below
Insert the name of each local government area in which the mobile and temporary ERA is proposed to operate/operating

Hoooaoaganao ag

Privacy

Council will use any personal information provided for the intended purpose only and for remaining in contact with you. Council is authorised to collect
this information in accordance with the Local Government Act 2009 and other Local Government Acts. Your personal information is only accessed by
persons authorised to do so. Your personal information is dealt with in accordance with council's privacy policy.

www.noosa.qid.gov.au [email protected] T 07 5329 6500
PO Box 141 Tewantin Qld 4565 ABN 97 969 214 121

Page 1 of 4