16992 DA Change to existing approval · 132000.200451.2

6.          Pre-request response notice                                            Does the request involve a State resource
                                                                                   prescribed under the Sustainable Planning
Has a pre-request response notice been given by a relevant
                                                                                   Regulation 2009, Schedule 14?
entity (e.g. a concurrence agency) for this request?
7      No                                                                 7 No
       Yes                                                                      Yes - complete Table C below
        If yes, please attach a copy of the notice.
                                                                          Table C - State owned resource
                                                                          Nature of State owned resource
C           Owner's consent                                           I
Is the owner's consent required for this request?
       No                                                                 Nature of evidence required
      Yes - complete either Table A or Table B below                            Evidence of allocation of /entitlement to, the resource
Note - If more than one owner of the land all owners' details are               Evidence the chief executive has agreed to the request
required.
                                                                                  Attach a copy of the evidence required above.

Table A - owner's consent provided on form
Owner's name/s                                                            NOTES: For question 8
                                                                          Section 370(3) and (4) of the Sustainable Planning Act 2009 requires
I/We, the above-mentioned owner/s of the land, consent to                 that if an application for the development approval were made at
the making of this request.                                               the time of making this request and evidence under section 264(1) of
Signature/s                                                               the Sustainable Planning Act 2009 would be required to support the
                                                                          application, this request must be accompanied by the written
Date                                                                      agreement of the chief executive from whom evidence would be
                                                                          required under section 264(1).
                                                                          Section 264 of the Sustainable Planning Act 2009 provides that if a
                                                                          development involves a State resource, a regulation may require the
Table B - owner's consent attached                                        application to be supported by certain evidence prescribed under
                                                                      I
Owner's name/s              -HERH1?A4i ?Ty LTD * TftE                     regulation. Schedule 14 of the Sustainable Planning Regulation 2009
                               GOQ     k t 2, W!i51 5 1                   prescribes the State resources for which evidence is required to be
                                                                          given, and the evidence required, to support the application.
       The owner's written consent is attached.

                                                                                   Applicant's declaration
NOTES: For question 7
Under section 371 of the Sustainable Planning Act 2009, if the
person making the request is not the owner of the land to which the
approval relates, the request must be accompanied by the owner's
consent.
However, owner's consent is not required if the approval:
                                                                          By making this request, I #ecl$re that all information in this
•    relates to land the was acquisition land to which section
     263(2)(d) of the Sustainable Planning Act 2009 applied when          request is true and correct.
     the application for the approval was made; or
•    is for building work or operational work for the supply of
     community infrastructure on land designated for the
     community infrastructure; or
•    the consent of the owner would not be required under section
     263(1) of the Sustainable Planning Act 20091f a development
     application were made for the requested change.
Also, owner's consent is not required if the Assessment Manager is
satisfied that.
•    the number of owners of the land make it impractical to obtain
     owners' consent, and the requested change does not materially
     affect the owners' land; or
•    having regard to the nature of the proposed change, the owner
     has unreasonably withheld consent and the requested change
     does not materially affect the owner's land.




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