img-330121357-0001

       
 

3. Nature of request (please tick ALL applicable categories)
O To change the development pS To change the development [F 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
extension. See Cireuwret «

 

 

 

 

    

4. Location of the premises
Unit No. [StreetNo G3 Steet TARLECANDS RD
Suburb COoeR.A

Plan type & plan no.

a KE_ 192.052

 
   
   
   

    

 
 

 

 

 

 

 

 

 

5. Concurrence Agencies
Was there one or more concurrence agencies involved in the original approval? By No
D 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.

Concurrence Agency Date copy given

 

 

 

 

 

 

6. Pre-request response notice

Has a pre-request response been given by a relevant entity (e.g. a concurrence agency) for this request?
5X{No [a Yes

If yes, please attach a copy of the notice.

 

 

 

 

ye Oh lla mordatT-r nhs

Is the owner’s consent required for this request? bd No

1 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 Table B — owner’s consent provided on form
in p We "1 ae

Owner's name/s CH S MARS, Owner's name/s

We, the above-mentioned owner/s of the land, consent O The owner's written consent is attached.

 

 

to the making of this request.

Signature/s y KAA _—

Date 26[3] tS”

an

 

 

 

 

 

 

 

 

 

 

 

 

 

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