SUPERSEDED Extension to existing application 07/0616 · 132007.616.2

     6.              Pre-request response notice                            8.        Does the request involve a State resource
                                                                                      prescribed under the Sustainable Planning
     Has a pre-request response notice been given by a relevant
                                                                                      Regulation 2009, Schedule 14?
     entity (e.g. a concurrence agency) for this request?
     IlNo                                                                         No
        Yes                                                                       Yes - complete Table C below
                  If yes, please attach a copy of the notice.
          IV,                                                               Table C - State owned resource
                                                                            Nature of State owned resource
C                    Owner's consent

     Is the owner's consent required for this request?
                No                                                          Nature of evidence required
                Yes - complete either Table A or Table 8 below                   Evidence of allocation of /entitlement to, the resource
     Note - If more than one owner of the land all owners' details are            Evidence the chief executive has agreed to the request
     required.
                                                                                    Attach a copy of the evidence required above.
     Table A - owners consent provided on form .                •'
     Owner's name/s                                                        NOTES: For question 8
                                                                           Section 370(3) and (4) of the Sustainable Planning Act 2009 requires
    I/We, the above-mentioned owner/s of the land, consent to              that if an application for the development approval were mode at
    the making of this request.                                            the time of making this request and evidence under section 264(1) of
    Signature/s                                                            the Sustainable Planning Act 2009 would be required to support the
                                                                           application, this request must be accompanied by the written
    Date                                                                   agreement of the chief executive from whom evidence would be
                                                                           required under section 264(1).
                                                                           Section 264 of the Sustainable Planning Act 2009 provides that if a
                                                                           development involves a State resource, a regulation may require the
    Table B - owner's consent attached                                     application to be supported by certain evidence prescribed under
    Owner's name/s                                                         regulation. Schedule 14 of the Sustainable Planning Regulation 2009
                                                                           prescribes the State resources for which evidence is required to be
                                                                           given, and the evidence required, to support the application.
            The owner's written consent is attached.

                                                                           9.'      Applicant's declaration
    NOTES: For question 7
 Under section 371 of the Sustainable Planning Act 2009, if the            Signature/s:
 person making the request is not the owner of the land to which the
 approval relates, the request must be accompanied by the owner's
 consent.
 However, owner's consent is not required if the approval:
 •        relates to land the was acquisition land to which section        By making this request, I declare that all information in this
          263(2)(d) of the Sustainable Planning Act 2009 applied when      request is true and correct.
          the application for the approval was made; or
•         is for building work or operational work for the supply of
          community infrastructure on land designated for the
          community infrastructure; or
•         the consent of the owner would not be required under section
          263(1) of the Sustainable Planning Act 2009 if a development
          application were made for the requested change.
Also, owner's consent is not required if the Assessment Manager is
satisfied that:
•         the number of owners of the land make it impractical to obtain
          owners' consent and the requested change does not materially
          affect the owners' land; or
•         having regard to the nature of the proposed change, the owner
          has unreasonably withheld consent and the requested change
          does not materially affect the owner's land.




PD-DA-FM401/1-30/04/2010                                                                                                     Page 2 of 2