Attachmetn A - Council Form · MCU15/0111.01

Page 2

ature of request (please tick ALL applicable eeyeleucn)
:O Tochange the development a To change the development {0 To extend the relevant period
| approval ' conditions ' before lapsing

' Please attach documentation outlining the detail of and the reasons and justification for the requested change or.
, extension. i

 

___ |Street No 19 /Street Trading Post Road
‘State QLD

  
  
 
 

' RP165418
| RP2t6922

   

 

5. Concurrence Agencies
Was there one or more concurrence agencies involved in the original approval? | 0 No
i "RW Yes-provide details below

Note — Under 8372 of the Sustainable Planning ‘Act 2008 th the person making the request i is required to give a copy of this request to all
concurrence agencies.
i Sag

   

inves.

 

7. Owner's consent

is the owner's consent required for this request? lo No =
i ia Yes- complete either Table A or Table B below

 

iNote — “if more than one owner of the land all owners’ details are required —

Table A — owner's consent provided on form

Walter Elliott Holdings Pty Ltd

 

iOwner'’s name/s
Orianda Maria Toffoli 1 ‘ / / :

i ilWe, the above-mentioned owner/s of the land, consent i ‘oO The owner's written consent is attached.
‘to the making of this request.

Owner's name/s

: Signature/s :

‘Date AV) tr [A 16 |

Page 2 of 4

Page 3

    

' NOTES: For question 7
' Under section 371 of the Sustainable Planning Act 2009, if the person making the request ts 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:

| ~  felates 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

: = 18 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 tf 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 matenally
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?

i EYNo | Yes — complete below details
. Nature of. State owned resource:
‘Nature of Evidence

 

 

   

 

 

\Attach a copy of the evidence required above

-NOTES: For question 8

' 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 eviderice prescnbed under regulation. Schedule 14 of the Sustainable Planning Regulation

2009 prescribes the State resources for which. evidence i 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
Happlication with Council. Should any of the details given in relation to this application be changed in the future, the
applicant shall ¢ advise Counc’ in writing prior to any such change being implemented. __

| Signature/s Eur Drige — ‘Date _

 

Page 3 of 4

Page 4

OFFICE USE ONLY

Application no

{Amount paid
Receiving Officer

pee enn

Initial

ce ee fn

| Date stamp

|

Leen LUCIAN Pretec

‘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.
jO.Cheque | Moneyorder | Mastercard O Visa
'Card number Expirydate | Amount $
‘Name on card - Signature of cardholder ;
1 ____|Phone _ |s a receipt required? Dyes ONo |

 

 

 

 

Page 4 of 4