Extension to Currency Period - REC16/0019.01

                                                                                                                                         Planning Act 2016
 This form must be submitted to Council accompanied by the applicable fee.                             s-s                <
                                                                                                                                  cc

 Attach extra pages if there is insufficient space on the form.                                          o     tr-;       O
 If Council was the Assessment Manager for the existing approval, and the approval                      &ued by the                hen a request to extend
 the relevant period for the approval is made to Council.                                           ^                     \\
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 All terms used on the form have the meaning given in the Planning Act 2016 or the Planning Regulation 2017.


 1. Applicant details
 Applicant name - individual or company^-;
 Contact Name              ■ /^selOZ . T
 Postal address
                      2-JZ-yJoYm rtvAct
 Suburb                        64 H~                                                  State ^                                  Postcodq^/,^^ ^
 Business phone                                                                Mobile
 Email address       (-/mLo 6/&&Q                                                                        Fax

 2. Owner’s consent
 Is the owner’s consent required for this request? Sjf No                        □    Yes - the written consent of the owner(s) is attached
                                                                                      to this extension application.
 Note - if more than one owner of the land all owners’ details are required

 3. Location of the premises
                                                                    Street
 Unit No.                          Street No
                                                  Si
 Suburb                                                                                State    ^6                             Postcode/^ 5 £

 Lot no.                           Plan type & Plan no.
 Jef -5sM                                   KP L2MSZ+
 4. Details of existing development approva subject to this extension application!
 Approval Type                              Application number                          Date issued                 Entity that gave the
                                                                                                                    development approval
 Q/Development Permit
 □ Preliminary Approval

 5, Further details
 Provide the currency period for this development approval


 Identify how long this application seeks to extend the currency period of this development approval. Note: reasoning to
 support the proposed extension should also be provided.

5 Kt fi/<£^~~ Yd‘6                                                            O/ofirL           > <I
 c
 Privacy
 Council will use any personal information provided for the intended purpose only and for remaining in contact with you. Council is authorised to collect
 this information in accordance with the Local Government Act 2009 and other Local Government Acts. Your personal information is only accessed by
 persons authorised to do so. Your personal information is dealt with in accordance with council’s privacy policy.

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