132007.1022.01 Extension to relevant period

7. Does the request involve a state resource prescribed under the Sustainable Planning Regulation 2009, schedule
14? (e.g. the application involves state land, or taking quarry materials. Refer to the notes at the end of this form for more
information)

       No                 Yes-the written agreement of the chief executive from whom evidence would need to be obtained
                    q
                          under the Sustainable PlanningAct2009, section 254(1) must be attached.



8. Has a pre-request response notice been given for this request?

       No

q     Yes-a copy of the pre-request response notice must be attached to this request


9. Is a copy of this request required to be given to another entity under section 372 of the Sustainable PlanningAct
2009? (refer to notes at the end of this form for more information)

       No
      Yes-complete Table F

Table F

A copy of this request has been provided to the entities identified below (provide details for each entity given a copy of the
request and the date the copy was given)

      Assessment manager for the
      original application

q     Concurrence agencies for the
      original application

q     Any other entity prescribed by
      a regulation


1o. Provide details of any other supporting information attached to this request



    l^ t' ti.       GZ    C^-c !^      -.           a




Notes for completing this template
• This template is not an approved form under the Sustainable PlanningAct2oo9. The entity responsible for deciding the
  request may have their own form for the purpose of making a written request to change an existing development approval.
  A change to an existing development approval may involve:
  o      a change to an approval given by the assessment manager
  o      a change to a condition imposed by a concurrence agency
  o      a change to an approval given by the Minister under a Ministerial call in
  c      a change to a condition imposed by the Minister under a Ministerial direction
  o      a change to an approval given by the Planning and Environment Court
                4                                                          eque ^I 0 Ci si   B!'            Ova     pJaie
                                                                                                   Version 1.1 March 2010