FM3002s Request to Change Existing Approval and-or Extension to Relevant Period - Signed · OPW11/0335

3. Nature of request (please tick ALL eu (or Cye reli (:t)]

( To change the development ' To change the development |B To extend the relevant period
approval conditions before lapsing

Please attach documentation outtining the detail of and the reasons and justification for the requested. change or.
[ extension.

 
 
  
  
 

 

4, Location of the ial

Unit No. | Street No 215 0 | Street David Low Way

Suburb _Peregian Beach [State QLD ~ |Postcode 4573

   
     

   

 

Peete ae cme Clare (ty

Was there one or more concurrence agencies involved in the original approval? |b No
a Yes-provide details below

 

Note - Under $372 of the Sustainable Planning Act 2009 the person making the request is required to give a copy of this request to all :
concurrence agencies.

 

NIL

 

 

6. Pre-request response notice

Has a pre-request response been given by a relevant entity (e. g. a concurrence agency) | for this request?
a No
if yes, please attach a copy of th

     

 

    

 

 

ees
Is the owner's consent required for this request? C1 No
ry Yes- ‘complete either Table A or Table B below

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

 

 

 

  

HE ee ues CUR
Thomco (No. 2087) Pty Ltd

    

Owner's name/s Lassen

'
| Owner's name/s

 

\We, the above-mentioned owner/s of the land, consent la The owner's written consent is attached,
to the making of this request. oe ee : :

  

Signature/s

Date | 9/¢ ory |

 

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