MCU12/0041 Development Application part 2 of 2 Plans and covering letters 429 Kennedys Rd Pomona

                  Coast
        ISunshine
         Council
                                                                                              Regional Strategy and Planning
                                                                                  Submitting Supporting Documentation Form

    1. Applicant details
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    Surname           K1"\ ovJ 1(..5                                             Given names        1~rre"
    Postal address       -
                             Max k/a                                                            Po Box      G3J
    Suburb                                                                                 ex                    i Postcode 4--S 6’3
                        c.oorO::f_
I Business phone ’S442. Ii. I L (                 A1H phone                 5"442          s- 0{I        I Mobile      o4-3’a L9S" g?..S
I Email address        O.{.(;"c-L- ""wasvt’veys. co/1’l. all                                             I Fax       ’S;4-4-L 5125
                                                     7




    2. Business details if different to above
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i Business name
    Postal address

I   Suburb

i Preferred contact person
                                                                            I State                              i Postcode

1 Business phone                                 i Alternate phone                                       /Mobile
I Email address                                                                                          !Fax




                                                                                                             11-312..\




                                                   (date     -

                                                                     today’s date if you are submitting items at the same time).
     I understand that the first copy submitted of any information is the legal binding document captured in Council’s
    records management d                     for assessing and determining development applications.

    Signature                                                                                           Date        I z..   12.....




       1 CD (in PDF format with each document not exceeding 40MB)plus five (5)hard copies of each document (for
                                                         .




    Development Application).
    o 1 CD (in PDF format with each document not exceeding 40MB)plus three (3)hard copies of each document (for
    Building Application)
    o         additional copies of plans/information
         _




    Privacy
                                                                                                                                             ---I
    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
I council’s privacy policy.

    www..uMhinecout.qld.gcw.a.lmail               nshinecoast.qld.gov.auIT 0754757272 F 075475 7m
    Lod Bag 72 Sunshine Coast Mail Centre QId 4560           I       A N 37 876 973913

    CaIoundra oftIce 1 Omrah Avenue Calounclra QId 4551          I    IIIaroochrdore o11-13Ocean S1reet Maroochydora QId 4558
    Nambour office Cnr Currie and Bury Streets Nambour Qld 4560              I    Tewantin oDic>> 9 Pelican Street Tewantin Qld 4565


    1 of 1    Regional Strategy and Planning Submitting Supporting Documentation Form                                       FM282/3/24/06/2011