NC Signed extension to currency · 132010.529.02

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

 

 

 

Page 2 of 4