OPW15/0197 - Request to Change Existing Approval Application

4. Location of the premises

 

Unit No. ‘StreetNo (p ‘Street HABITAT PLACE
Suburb OOSA Ats State Qi Postcode ASG
Lot no. en type & plan no.

 

18 RP Foobeye

 

5. Concurrence Agencies
Was there one or more concurrence agencies involved in the original approval? No
0 Yes-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

6. Pre-request response notice

Has a pre-request response been given by a relevant entity (e.g. a concurrence agency) for this request?
No O Yes

If yes, please attach a copy of the notice.

 

 

7. Owner’s consent

'Is the owner's consent required for this request? /|O No
{-Yes— complete either Table A or Table B below
Note — If more than one owner of the land all owners’ details are required

Table A — owner’s consent provided on form Table B — owner’s consent provided on form

GeRDon Neel HeeFoRD
PEUNDA TANE HERFERN

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

Signature/s Z, = WZ

| Date

Owner's name/s Owner's name/s

Page 2 of 4