NC Signed extension to currency · 132010.529.02

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3. Nature of request (please tick ALL applicable categories)

 

O Tochange the development O To change the development M 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.

4. Location of the premises
Unit No. |StreetNo 28 Street Hastings Street
Suburb Noosa Heads State Qld Postcode 4567

 

 

5. Concurrence Agencies
Was there one or more concurrence agencies involved in the original approval? WM No

 

 

Note — Under s372 of the Sustainable Planning Act 2009 the person making the request is required to give a copy of this request to all
concurrence agencies.

Over eK ome TLR

 

6. Pre-request response notice

Has a pre-request response been given by a relevant entity (e.g. a concurrence agency) for this request?
WNo oo "TOYes —™ a

If yes, please attach a copy of the notice. '

 

Teeey leet tat

 

Is the owner’s consent required for this request? a No
Yes— complete either Table A or Table B below

Note — lfm more e than one owner er of ‘the fa land all owners’ details are re required oe

 
    

L Steftian ¢ 1Ue
DREcTCR CHoAMbe Wars

We, the above-mentioned owner/s of the land, consent 5] O The owner's written consent is attached.
to the making of this request.
: Signature/s A (et LK te. |
Date |
Z2kI 3] 1, :

Owner's name/s

Owner’s name/s

 

 

 

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Page 3

 

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
-  |s 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?
(No
' Nature of State owned resource:

   

O Yes — complete below details

oO Evidence of allocation of / entitlement to, the resource QO Evidence the chief executive has agreed to the request _

|
|
Nature of Evidence required: ; |

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 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 - Ss

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 WE, Oct-e_ ‘Date ly - 3- wry

 

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Application no. | Amount paid Date paid Receipt no. Initial Date stamp

| Receiving Officer _ _ —_ '

 

 

 

 

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.
O1 Cheque | Money order Ufastercard | O Visa

Card number S\ \e3 lo3e (AG LAR Expiry date O22 } ons 7 (68). SO
on | ‘oe = hte

Name on card CTERIEN Pos: an : Signature of cardhol

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Phone Ot | ff SI S| ‘Is a receipt required? te ONo

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