16992 DA Change to existing approval · 132000.200451.2

,, Sunshine
   Regional Council
                    Coast                                    Request to Change Existing Approval and/or
                                                                    Extension to Relevant Period

NOTES:                                                                     Which entity issued the approval?
ALL questions MUST be completed unless the form indicates                           Sunshine Coast Regional Council (PLC-,* c1X) l         t-)
otherwise.                                                                          Other entity - please specify:
This form must be submitted to Council accompanied by the
                                                                           Is the approval for a mobile and temporary ERA?
applicable fee.
Attach extra pages if there is insufficient space on the form.                      No

If Council was the Assessment Manager for the existing approval,                    Yes - complete below
and the approval was issued by the Court, then:-
                                                                           Insert the name of each local government area in which the
(a)      a request to change the development approval and/or               mobile and temporary ERA is proposed to
         conditions is mode to the Court, and
                                                                           operate/operating.
(b)      a request to extend the relevant period for the approval is
         mode to Council.
All terms used on the form have the meaning given in the
Sustainable Planning Act 2009 or the Sustainable Planning
Regulation 2009.                                                           3.            Nature of request

                                                                           Please tick ALL applicable categories
1.         Details of the person making the request
                                                                                    To change the development approval
Full name - individual or company                                                   To change the development conditions

-HEP^}21                         LT                                                 To extend the relevant period before lapsing
                   1
Contact name -for company                                                            Please attach documentation outlining the details of
                                                                                     and the reasons and justification for the requested
 &-oir ScN3E1^
                                                                                     change or extension.
Postal address
G/- (}IA-               VE^,IJI't^G.T[^ T` A4        EKS
                                                                       1                 Location of the premises                                 l
Pa        x 6360 '                        SAKE                             Street address
     &T)                                    Postcode      1-SEe            Unit no.        Street no.   Street name

Contact phone number                  Fax number - if applicable
                                                                                                            WSTt1i43 S            ST
                                                                           Suburb                                        Postcode
                                                                                N                       5                    67
Mobile number - if applicable

     0-ro -775              35                                             Lot and plan description
                                                                           Lot no.         Plan type & plan no.
E-mail address - if applicable
                                                                                1            SP (3-166
scan-. iSa* Q, kIIAW%Ck6 . cowl . IQ                                        CP              P 13i 636
2.         Details of the existing approval
Type of approval - please tick ALL applicable categories
        Development Permit
        Preliminary Approval                                               5.            Concurrence Agencies

        Compliance Permit                                                  Was there one or more concurrence agencies involved in
        Material Change of Use                                             the riginal approval?
        Reconfiguring a Lot                                                         No
        Operational Works                                                           Yes - provide details below
        Building Works                                                     Note - Under s372 of the Sustainable Planning Act 2009 the person
        Plumbing or Drainage Works                                         making the request is required to give a copy of this request to all
                                                                           concurrence agencies.
        Compliance Certificate
        Environmentally Relevant Activity (ERA)                            Concurrence Agency                            Date copy given

Application number               Date issued
                                                                                                                              /     /
                                                  27 / 1 / 2000
      2()-7-19         4-                         r-1 q-( ZC01




PD-DA-FM401/1-30/04/2010                                                                                                    Page 1 of 2