Development Application part 1 of 2 · OPW11/0409

18. Is owner's consent required for this application? (refer to notes at the end of this form for more information)


    [] No

    ® Yes - complete either table D. table E or table F as applicable


i
    Table D (note: do not complete this table if lodging the application on-line using Smart eDA)



    Name of owner/s of the land


    I/We, the above-mentioned owner/s of the land, consent to the making of this application



    Signature of owner/s of the land                                                  (6'7 Fjt,%+ x/11 ^^i


    Date                                          10      ZOI


    Table E


    I Name of owner/s of the land

     n The owner's written consent is attached or will be provided separately to the assessment manager


    Table F


     Narne of owner/s of the land

           By making this application. I. the applicant. declare that the owner has given written consent to the making of
           the application


    9. Does the application involve a state resource? (e.g. the application involves state land, or taking quarry
    materials. Refer to the notes at the end of this form for more information)


        No                           0 Yes - complete table G