09/1490 - Request to change existing approval & drawings [As Published] · 132009.1490.02

 

 

 

 

 

INTEGRATED PLANNING ACT 1997 — —— Form 2, Version 4.1, 3 March 2008
3(b) Can the address be further described by shop/tenancy number or storey/level?

EX No [] Yes-— Complete Table C
Table C} = Shop/tenancy number Storey/levet
1,

 

 

 

 

 

 

 

4. Can the premises best be identified by coordinates (e.g. for development proposed in waters, or on a site within a large rural lot)?

 

 

 

 

 

 

 

 

 

 

 

 

 

CY No [-] Yes — Complete Table D
Table D
Coordinates Zone Local government area
(Note: place each set of coordinates in a separate row) Datum g
: Reference (If applicable)
Easting Northing Latitude Longitude
1. [-] GDA94 [.] WGS84
[7] Other
5. What is the total area that makes up the premises (ie. the area covered by the application)?
Area of land above high water mark/outside watercourse Area in a water body or watercourse
LOA! KJ m2 [hectares (Tick applicable unit) [J m2  [[] hectares (Tick appticable unit)

 

 

 

 

 

Owner’s consent and resource owner’s agreement

6. {(s the person making the request the owner of the land to which the approval attaches?

[1 Yes we No ~ Complete Table E - provide details for each owner on a separate row, or on an attachment to this form if applicable. Note: Advice
provided at the end of this form details when owner's consent Is not required.

 

Table E Details of the
premises owned . * Date consent
Owner's namels and postal address 2 aadrass or loton plan description) Signature was obtained

1 1MO.G. WILLS) Po. bX SS w 1/4 ho
BUMUNID 1 & .
| ASGZ . Lier

7. If an application for the existing approval were being made now (i.e. at the time of making this request), would evidence be required to
support the application because it involved taking or interfering with a State-owned resource prescribed by schedule 10 of the

integrated Planning Regulation 1998 (IP Reg) or any other regulation
wae No [} Yes- Complefe Table F and submit, with the application, written agreement to the request.

 

 

 

 

 

 

 

 

Table F Date written agreement of the chief
Nature of State-owned resource Relevant State Government Department executive was obtained

 

 

 

 

 

 

Nature of the request

8. Whatis the nature of the request for change? (Tick the applicable box/es)
[] Anextension of the period before an approval lapses (under IPA, section 3.5.22)
[J To change the development approval other than a change of condition (under IPA, section 3.5.24)
J To change or cancel a condition of approval (under IPA, section 3.5.33) - Go fo Q11

LJ Tochange conditions of a rezoning approval given under the Local Goverment (Planning and Environment) Act 1990 (under iPA,
section 6.1.35A)- Go to Q12

9. Were one or more concurrence agencies involved in the approval?

No

* Owner's signature can not be provided on the form if you intend to submit the application electronically. Owner's consent must be provided to the assessment manager on
an attachment containing appropriate written documentation of the owner's consent. If the owner is a company the company must sign as owner. $127 of the
Corporations Act 2001 (Cwealth) details how a company may execute a document.

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