13441 Loa · OPW16/0125

(SGU

TO WHOM IT MAY CONCERN

AUTHORITY TO LODGE MARINE BERTHING APPLICATIONS

As the registered owner/s of the property described below, Ive hereby authorise
Superior Jetties to lodge any applications associated with the required approvals for a
marine structure adjacent to the specified land and to make any required enquiries in
regard to such applications on my/our behalf.

Address of Property:

28... MMe, wa los. Nbesh | Menoe essere POSt Code... 456Z. cco
Lot Number: hog (2. Plan Number...... v 2IS¢L cectteneeeaeeaeeseaseneagees

Registered Owners:

NAME IN FULL SIGNATURE DATE
2
Beata Fr ke be, ele