Change to an Existing Approval-132009.325.01

  3. Nature of request (please tick ALL applicable categories
   LI     To change the development                             change the development                                                            (q    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.


 14. Location of the premises




   Was there one or more concurrence agencies involved in the original approval?                                                                       '' No
                                                                                                                                                       q 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.




 6. Pre-request response notice
   Has a pre-request response been given by a relevant entity (e.g. a concurrence agency) for this request?
 VIVO
 If yes, please attach a copy of the notice.


17. Owner's consent
 Is the owner's consent required for this request?                                            q No ............................................
                                                                                                                    ...  .............. ...................
                                                                                              VYes- complete either Table A or Table B below
 Note - If more than one owner of the land all owners' details are required




                                         M
 Owner's name/s                                        1      1 4
                                                           -40Y{
                                                              ^_... . .....................
 I/We, the above-mentioned owner/s of the land, consent
   to the making of this request.
:...................................................
 Signature/s                                                                                                q The owner's written consent is attached.




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