06/0823 - Change to Development Approval [As Published] · 132006.823.03

 

INTEGRATED PLANNING ACT 1997 Form 2, Version 4.1, 3 March 2008
3(b) Can the address be further described by shop/tenancy number or storey/evel?

ho 1 Yes~ Complete Table C
Table C; — Shopfienancy number Storeyflevel
1.

 

 

 

 

 

 

 

4. Can the premises best be identified by coordinates (e.g. for development proposed in waters, or on a site within a large rurat lt)?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

No (1 Yes — Complete Table 0
Table D
Coordinates
(Note: place each set of coonfinates in a separce row) R fone Datum saeat (elilvel tala
Easting Northing Latitude Longitude F
1. ( cpass (1) wese4
LD Other
5.  Whatis the total area that makes up the premises (.e. the area covered by the appication)?
Area of land above high water marW/outside watercourse Area in a water body or watercourse
S. 336 Time [fecares (rick apptcable nip | Cm | __tares (Tick apptcable unip
Owner's consent and resource ow owner's agreement . _ __ _
6. 1s the person making the request the owner of the land to which the approval attaches?
Yes (0 No ~- Complete Table E - provide detaits for each owner on a separate row, or an an attachment fo this form if applicable. Note: Advice
provided at the end of this form detais when owner's consent is not required.
Table E Details of the premises owned , Date consent
Owner's name/s and postal address (street or ioton plan intion) Signature* was obtai

 

 

 

 

 

 

 

 

7. _ If an application for the existing approval were being made now (i.e. af the time of making this request), would evidence be required to
support the application because it involved taking or interfering with a State-owned resource prescribed by schedule 10 of the
fed Planning Regulation 1998 (IP Reg) or any other regulation

 

 

 

 

 

 

 

 

No (1 Yes — Complete Table F and submit, with the application, written agreement to the request.
Table F Date written agreement of the chief
Nature of State-owned resource Relevant State Govemment Department executive was obtained
1.
Nature of the request

8. W What is the nature of the request for change? (Tick the epptcatie pox/es)
(| Anextension of the period before an approval lapses (under IPA, section 3.5.22)
To change the development approval other than a change of condition (under IPA, section 3.5.24)
(2 To change or cancel a condition of approval (under IPA, section 3.5.33) - Go to Q11
(1 Tochange conditions of a rezoning approval given under the Local Goverment (Planning and Environment) Act 1990 (under IPA,
section 6.1.35) - Go to Q12

9. Were one or more concurrence agencies involved in the approval?

* Owner's signature can not be provided on the form if you intend to submit the application electronically. Owner's consent must be provided to the assessment manager on
an attachment containing appropriate written documentation of the owner's consent. If the owner is a company the company must sign as owner. $127 of the
Corporations Act 2001 (Cwealth) details how a company may execute a document.

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