NC change form signed · OPW16/0021

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4. Location of the premises
| Unit No. 'StreetNo 74 ‘Street Seaview Terrace
Suburb Sunshine Beach State Qld |Postcode 4567
Lot no. | Plan type & plan no.
4 RP197117

5. Concurrence Agencies
| Was there one or more concurrence agencies involved in the original approval? WNo
|

O Yes-provide details below

|Note — Under $372 of the Sustainable Planning Act 2009 the person making the request is required to give a copy of this request to all
| concurrence agencies.

Concurrence ty ; - ; : ee copy PCat

 
 

6. Pre-request response notice

| Has a pre-request response been given by a relevant entity (e.g. a concurrence agency) for this request?
| No 0 Yes
|If yes, please attach a copy of the notice.

Oem 8

Is the owner’s consent required for this request? /O1 No

| | MW Yes— complete either Table A or Table B below
— If more than one owner of the land all owners’ details are required ae

  

     

BE Ne Reon alot a ecod Sr-Tl eed conaCe (let i011 Se aera

 

BE ICHSex VC cot Ue Neds (eR ee ee
| |

rty C Establishment | .
Unversal Property Company | Owner’s name/s

Owner's name/s

| We, the above-mentioned owner/s of the land, consent | The owner's written consent is attached.

‘to the making of this request. Y/
| Signature/s Ww
Date

40, AUG. 2016

 

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| NOTES: For question 7

| 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

|
| - 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.

8. Does the request involve a State resource prescribed under the SustainablePlanning Regulation 2009,
Schedule 14?

| BXNo | Yes — complete below details
Nature of State owned resource:

| Nature of Evidence required:

io Evidence of allocation of / entitlement to, the resource |O Evidence the chief executive has agreed to the request
| Attach a copy of the evidence required above
NOTES: For question 8 ey Se

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
the 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 applicant

We, 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 any such change being implemented.

| Signature/s Date 10, AUG. 2016

 

 

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|Applicationno. =| Amount paid Date paid | Receipt no. Initial | Date stamp

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| Receiving Officer

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Payment options

|In person 9 Pelican Street, Tewantin: 8.30 am to 4.30 pm Monday to Friday (excludes public holidays).
By mail Cheque or money order to be made payable to Noosa Council.
C1 Cheque | Money order | Mastercard O Visa

All payments made by credit card will incur a 0.50% surcharge (exempt of GST) to reflect the cost of fees
charged for credit card transactions.

  

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