Signed Request to Change Existing Approval

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4. Location of the premises

Unit No.

| Street No: 70

| Street: Carpenters Lane

 

 

   

Ci

Suburb: Cooroy
ee

SP248288

| State: QLD

  

| Postcode: 4565

 

 

$P242414

 

 

 

 

5, Concurrence Agencies

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

O 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. : cae ;

ence Agen Ee Lo
State Assessment and Referral Agency (SARA QLD NORTH)

 

 

  
 
 

     

toe My ;
12 November 2014

 

 

 

6. Pre-request response notice

Has a pre-request response been given by a relevant entity (e.g. a concurrence agency) for this request?

 

 

 

 

 

 

X No [Yes

If yes, please attach a copy of the notice.

mee Teme

Is the owner's consent required for this request? X No

 

 

O Yes— complete either Table A or Table B below
Note — If more than one owner of the land all owners’ details are required

 

    

Owner's name/s

 

 

enna | Owner's name/s

 

We, the above-mentioned owner/s of the land, consent
to the making of this request.

 

O The owner's written consent is attached.

 

 

Signature/s

Date

 

 

 

 

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| NOTES: For question 7

Under section 371 of the Sustainable Planning Act 2009, if the person making the request is not the owner of the land to which the
| approval relates, the request must be accompanied by the owner's consent.

| However, owner's consent is not required if the approval:

| -  felates to land the was acquisition land to which section 263(2)(d) of the Sustainable Planning Act 2009 applied when the |
| application for the approval was made; or

- is for building work or operational work for the supply of community infrastructure on land designated for the community
| infrastructure; or

lez the consent of the owner would not be required under section 263(1) of the Sustainable Planning Act 2009 if a development |
application were made for the requested change.

Also, owner's consent is not required if the Assessment Manager is satisfied that:

| - the number of owners of the land make it impractical to obtain owners’ consent, and the requested change does not materially
| affect the owners’ land; or

- having regard to the nature of the proposed change, the owner has unreasonably withheld consent and the requested change
does not materially affect the owner's land.

8. Does the request involve a State resource prescribed under the SustainablePlanning Regulation 2009,
Schedule 14?

X No O Yes - complete below details
Nature of State owned resource:
| Nature of Evidence required:

 

(1 Evidence of allocation of / entitlement to, the resource | O Evidence the chief executive has agreed to the request
Attach a copy of the evidence required above
NOTES: For question 8

Section 370(3) and (4) of the Sustainable Planning Act 2009 requires that if an application for the development approval were made at
the time of making this request and evidence under section 264(1) of the Sustainable Planning Act 2009 would be required to support

the application, this request must be accompanied by the written agreement of the chief executive from whom evidence would be)
required under section 264(1). |

| Section 264 of the Sustainable Planning Act 2009 provides that if a development involves a State resource, a regulation may require |
| the application to be supported by certain evidence prescribed under regulation. Schedule 14 of the Sustainable Planning Regulation
2009 prescribes the State resources for which evidence is required to be given, and the evidence required, to support the application.

9. Declaration of applicant

|IWe, the applicant, declare that the above information is correct in all respects, at the time of lodgement of this |
application with Council. Should any of the details given in relation to this application be changed in the future, the
applicant shall advise Council in writing prior to any such change being implemented.

hs
|Signaturels 4/7 22-C 2 Ort ‘Date PTE. OL IE

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OFFICE USE ONLY

Application no: | Amount paid Date paid Receipt no. Initial Date stamp -

  

 

 

 

 

 

 

 

 

Receiving Officer

 

 

 

Payment options

Inperson |9 Pelican Street, Tewantin: 8.30 am to 4.30 pm Monday to Friday (excludes public holidays).

  

 

 

 

 

By mail Cheque or money order to be made payable to Noosa Council. |
O Cheque io Money order jo Mastercard io Visa |

 

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