142009.1227.01 Operation Works Chane Application

  

4. Location-of the ous :
Unit No. - ‘StreetNo tb {
Suburb Nez 4

      
 

 
   

 

 

 

 

5. Concurrence.Agencies
Was there one or more concurrence agencies involved in the original approval? ENo
: 1 Yes-provide details below

 

_ Note ~ Under s372 of the Sustainable Planning Act 2009 the person making the. fequest is‘ required to give a copy of this eaves! to all |
_concurrence agencies. : :

  

 

 

6./Pre-réequest response notice. :

Has a pre-request response been given by a relevant entity (e.g. a concurrence agency) for this request? :
BANo 'O Yes :
If yes, please attach a copy of the ni :

 

 

 

 

Tee oe Rene ; a

| Is the owner's consent required for this request? ‘& No
i a Yes- complete « either Table A or Table B below
“Note - - If more than one owner of the land all owners’ details ‘are tequired | Bese :

 

 

 

 

 

  
       

PAR SHoee PESaet

“Owner's name/s Fave Soe — ‘owners names Bopy C0 Petre

“we, the above-mentioned owner/s of the land, consent o The owner's written consent is attached.
to the making of this request.

     

i

 

  
  

   

: Signature/s

Seorr PTY UAT

 

 

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