06/1168 Consent to application by delegated officer of SCRC.pdf [As Published] · 132006.1168.02

 

Table C—premises coordinates (appropriate for development in remote areas, over part of a lot or in water e.g. channel

dredging in Moreton Bay)

 

Coordinates
(note: place each set of coordinates ina

Zone

separate row) reference

 

Easting Northing

Latitude

Longitude

Datum Local government

area (if applicable)

 

 

 

 

 

 

[| spAgg
[] weseq
C] Other

 

 

 

5. Detalls of the proposed change

 

 

Set ATAcHed ScHedoie A

 

 

 

 

6. Is owner’s consent required for this request? (refer to notes at the end of this form for more information)

 

[] No

Xl Yes-—complete either table D or table E as applicable

 

Table D

 

Name of owner of the land

Sonspine Coast Counc

 

|, the above-mentioned owner of the lan

d, consent to the making of this request.

 

y-

Signature neyof the land
A 5 on awe
L
Y

DPauip The mars .

 

Date

S/S ft

 

 

Table E

 

Name of owner of the land

 

 

 

E | The owner’s written consent is attached

 

 

 
 

      

art GxISUM CME TE:

ap!
Version 1.1 March 2010