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Pre_Request_Response_Form NSC · 131999.982963.6

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                                                                                                   Pre-Request Response Application



                                                                                                                                   Planning Act 2016
ALL questions MUST be completed unless the form indicates otherwise.
This form must be submitted to Council accompanied by the applicable fee.
Attach extra pages if there is insufficient space on the form.
All terms used on the form have the meaning given in the Planning Act 2016 or the Planning Regulation 2017.

1. Details of person making the request
Full name – individual or company Robyn & Ross Wilson
Contact Name – for company Greg Martoo @ Martoo Consulting
Postal address care of Martoo Consulting - P.O. Box 1684 NOOSA HEADS
Suburb Noosa Heads                                                                    State Qld                          Postcode 4567
Business phone                                      A/H phone                                           Mobile 0409632830
Email address [email protected]                                                                 Fax N/A

2. Details of existing approval
Type of approval (please tick ALL applicable categories)                      Which entity issued approval?
     Development Permit                                                          Council
     Preliminary Approval                                                        Planning & Environment Court
     Material Change of Use                                                      Minister (under part 11, division 2)
     Reconfiguring a Lot                                                         Other entity – please specify
     Operational Works
     Building Works
     Plumbing or Drainage Works
     Environmentally Relevant Activity
Application number/council reference 12592DA                                                                         Date issued June, 2003
Is the approval for a mobile and temporary ERA?                                                   No                     Yes – complete below
Insert the name of each local government area in which the mobile and temporary ERA is proposed to operate/operating
N/A

3. Nature of proposed change/s (please tick ALL applicable categories)
To change the development approval issued by:                                 To change the conditions issued by;
     Planning & Environment Court                                                Planning & Environment Court
     Minister                                                                    Council (as a Concurrence agency)
     Other entity – please specify:                                              Minister
                                                                                  Concurrence Agency – please specify:
                                                                                  Other entity – please specify:
Please attach documentation outlining the detail of and the reasons and justification for the requested change/s.




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.


www.noosa.qld.gov.au                        [email protected]                       T 07 5329 6500
PO Box 141 Tewantin Qld 4565                                                            ABN 97 969 214 121

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 4. Location of the premises
 Unit No.                   Street No 20              Street Bayview Road
 Suburb Noosa Heads                                                 State Qld                   Postcode 4567
 Lot no.                    Plan type & plan no.
Originally (1) Lot 1 &      Originally (1) RP136508 & (2) GTP103170
(2) Lots 1 and 2
 Currently Lot 5            SP174659




 5. Declaration of applicant
 I/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                                                                               Date


 OFFICE USE ONLY
 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 Link      A payment link will be forward to you once your application has been lodged.
 By mail      Cheque or money order to be made payable to Noosa Council.
               Cheque                                          Money order

                                                                                                                Page 2 of 2

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