132006.2361.01 Request to Extend the relevant period 25 Grant St Noosa Heads

     5Llnshine Loast                                         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
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.              V'    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 made to the Court; and
                                                                           operate/operating.
 (b)    a request to extend the relevant period for the approval is
        made to Council.
 All terms used on the form have the meaning given in the
 Sustainable Planning Act 2009 or the Sustainable Planning
 Regulation 2009.                                                         C            Nature of request

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

I Sew4c: 77 49r_"              GilA. ASs"tA T                                     To extend the relevant period before lapsing

 Contact name -for company                                                           Please attach documentation outlining the details of
                                                                                     and the reasons and justification for the requested
                                                                                     change or extension.
 Postal address
                                                                           4.          Location of the premises
  / O. Box 4-8 S
  AVA i o J ,g6RGH.                                                        Street address
  NSl--i.                                   Postcode      Z/0-)-           Unit no.      Street no.    Street name

 Contact phone number               Fax number - If applicable
                                                                                            2s             6-,e,Aa1 sreEEr
                                                                           Suburb                                        Postcode
02     9991- 02u1 .                  0z     8999 - 2581.
                                                                                A.AOOSA ' EAL^G .
 Mobile number - If applicable
       04-18. 8& 86 t4-1                                                   Lot and plan description
                                                                           Lot no.       Plan type & plan no.
 E-mail address - if applicable
                                                                          Lod 7.          XP
  4nne.jfarv h tta7S              o Q.w.a^:         Cci . atu^
                                                                                         PARrsH .Of             IJEy&A-.

 2.        Details of the existing approval

 Type of approval - please tick ALL applicable categories
        Development Permit
        Preliminary Approval                                               S.          Concurrence Agencies

        Compliance Permit                                                  Was there one or more concurrence agencies involved in
        Material Change of Use                                             the original 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                                                                                    /    /
       2 oar J 236/                               ZS/OS/ 2                             7Z
                                                                                             och      PA                      /    /
                                                                      De4 e opmeM
                                                                                 16 MAR 2011

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