Change to development approval - Form 132003.220808.6

r-------:I
 o     Environmentally Relevant Activity                                f
Application number/council reference                                                                       I Date issued
 Is the approval for a mobile and temporary ERA?                                       0    No              0 Yes       -

                                                                                                                         co,!,plete below
 Insert the name of each local government area in which the mobile and temporary ERA is proposed to operate/operating
                                _-      -   --




       To change the development                 0    To change the development                   0    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.




 Was there one or more concurrence agencies involved in the original approval?

                                                                                                      o Ves-provide details

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.
Concurrence Agency                                                                                    Date copy given




 Has a pre-request response been given by a relevant entity (e.g. a concurrence

                                                                    DYes




                                                                                              -




7. Owner’s consent

Is the owner’s consent required for this request?                     loNo
                                                                      10 Ves- complete either Table A or Tab/e B below
Note   -
         If more than one owner of the land all owners’ details are required.




                                                                                                  J
                                                                            l!We the above-mentioned owner/s of the land, consent

20f4                   2012/13 Regional Strategy and Planning Request to Change Existing Approval and/or Extension to Relevant Period FM3002s
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