10/0628 - MCU - Retail Business Type 2 [As Published] · 132010.628

 

 

 

ent Fegured for his application? (lero note,

    

 

 

&] Yes - complete either table D, table E or table F as applicable

 

Table D (note: do not complete this table if lodging the application on-line using Smart eDA)

 

 

Philip John Bacon
Name of owner/s of the land [Brent Anthony Ogilvie

 

\We, the above-mentioned owner/s of the land, consent to the making of this application.

Signature of owner/s of the land #7 LY fae oo 4 Woe.
t

Date “Oo Ax wt Ore

 

 

 

 

 

Table E

 

 

Name of owner/s of the land

 

 

(| The owner's written consent is attached or will be provided separately to the assessment manager

 

Table F

 

 

 

Name of owner/s of the land

 

Oo By making this application, |, the applicant, declare that the owner has given written consent to the making of
the application.

 

 

 

 

 

 

 

(4 __ adjacent to a water body, watercourse or aquifer (e.g creek, river, lake, canal) - complete table H
CJ _ on strategic port land under the Transport Infrastructure Act 1994 - complete table |
C1 __ ina tidal water area - complete table J

 

 

 

 

 

No [(] Yes - ensure the type, location and dimension of each easement is included in the plans submitted

 

Application Details - {DAS form 1
Version 1.0 18 December 2009