Appendix D - Noosa Council Form · 132008.1128

3. Nature of request (please tick ALL applicable categories)
[WY To change the development O To change the development [ 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.

  

4. Location of the premises

Unit No. Street No Street Gatcipee COWL ) uUnnse Beach

Suburb State A\ Postcode 4-56 7

b Raise
A SH252905

     

Emm Leave icra ms (UC cr}

Was there one or more concurrence agencies involved in the original approval? O No

wes-provide details below

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
Dept. of Natural £eS ouIcel aNd ines .
Dept. of Environment and Hentag a Pmechon

 

 

§, Pre-request response notice

 

Has a pre-request response been given by a relevant entity (e.g. a concurrence agency) for this request?
No Cl] Yes
If yes, please attach a copy of the notice.

AON meals

 

Is the owner's consent required for this request?

oe
'™@ Yes— complete either Table A or Table B below
Note — If more than one owner of the land all owners’ details are required

 
       

wner's name/s wner’s name/s THe Unitin Churn ns
0 is ° * AySHalia Hapery Tur’

We, the above-mentioned owner/s of the land, consent {The owner's written consent is attached.
to the making of this request.

Signature/s

Date

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