1. Application Form

Date: 4 February, 2019

Chief Executive Officer

Noosa Council

PO Box 141

Tewantin QLD 4656

To whom it may concern,

RE: LANDOWNER CONSENT FOR REQUEST TO CHANGE DEVELOPMENT
APPROVAL AT 5 MEMORIAL AVENUE, TEWANTIN (TEWANTIN RSL)

We, TEWANTIN NOOSA RSL & CITIZENS MEMORIAL CLUB INC as owner of the land
described below:

Subject Land

Lot 10 on SP273411
5 Memorial Avenue, Tewantin

Consent to Rubicon Design & Construct Pty Ltd C/- Planit Consulting Pty Ltd lodging the
Development Application described below:

Application

= Request to Change Development Approval (Minor Change)

Signed on behalf of Tewantin Noosa RSL & Citizens Memorial Club Inc,

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Signature Signature

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Print Name Print Name
Asuslant CEO PA
Position Position

Note: Where the owner is a Company/Corporation, the signatures of two company directors are
required or a director and company secretary. Alternatively, if the Company is a Sole Director
Company, then please state as much and only one signature is required.