Request to Extend Relevant Period 132007.616.03

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                                                                                                 To change the development                 ~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
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extension.
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Was there one or more concurrence agencies involved in the original approval?

                                                                                                                                                   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.
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Concurrence Agency                                                   -
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                                                                                                                                         ’. t.     Date copy given
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Has’a:pre-req~est.response been ~i~~f\fy a relevant entity (e.g. a concurrence agency)for this request?
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                                                                                                              0Yes
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If yes, please att~s~ a_copy of the’notice:-                                                                                                      .,



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                                                                                                               o Yes- complete either Table A or Table B below

Note    -
            If more than one owner of the land all owners’ details are required



Table A        -
                     owner’s consent provided on form


Owner’s name/s


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


                                                                                                                     o The owner’s written consent is attached.
Signature/s




2 of 4                                 2013/14 Regional Strategy and Planning Request to Change Existing Approval and/or Extension to Relevant Period FM3002s