Change to Existing Approval - OPW11/0116.01

3. Nature of request (please tick ALL applicable categories)

)& To change the development                                   )To change the development                                                                              i
                                                                                                                                                                            0           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 ofthe premises
                                                                                         .

.
    Unit No.                             : Street No                                         Street                                                                           ~k.,~ D(lYe....




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    5. Concurrance Agencies

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

,
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: ~t~"::: -;;d;;’~3i2~’fth~ s’~;;;~;bi~F;;;;;~gA~ 2 9’h~ -p;;;~~ ;:;:;~k~g the req~;; ’i~’;~Quiredtc;’9i~;’~’~~py~f’lhi~-;:~~~st to ’~II
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    concurrence          agencies.

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    6. Pre-request response notice

     Has a pre-re,quest response been given by a relevant entity (e.g’, a concurrence agency)for this request?
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    If yes, pteas            atfch a copy of the notice.                   .
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    7. Owner’s consent

     Is the owner’s consent required for this request?
                                                                                                              :~!’J.’?__
                                                                                                               o Yes- complete either Table A or Table B below
                                                                                                                     ...                    .’   ....._. ..-...                               ..




     Note   -
                  If more than one owner of the land all owners’ details are required
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                                                                                                                                  Date

     Owner’s name/s
                                                                                                                                   .
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     IM/e, the above-mentioned ownerls of the land, consent
     to the making of this request.
                                                                                                                                  Owner’s name/s


                                                                                                                                  o The owner’s written consent is attached.
     Signature/s




     2 of 4           2011/12 Regional Strategy and Planning Request to Change Existing Approval and/or Extension to Relevant Period FM401