SUPERSEDED Extension to existing application 07/0616 · 132007.616.2

               Pre-request response notice                                  l    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?
    ent i ty (e.g. a concurrence agency) f or t hi s request ?

                                                                                       No
B Yes                                                                                  Yes - complete Table C below
             If yes, please attach a copy of the notice.
                                                                                 Table C - State owned resource
                                                                                 Nature of State owned resource
C              Owner's consent                                          I
    Is the owner's consent required for this request?
           No                                                                    Nature of evidence required
     z                                                                                 Evidence of allocation of /entitlement to, the resource
          Yes - complete either Table A or Table B below
    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 - owner's 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 on 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
                                                                                agreement of the chief executive from whom evidence would be
    Date
                                                                                required under section 264(1).
                                                                                Section 264 of the Sustainable Planning Act 2009 provides that if o
                                                                                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.

                                                                                         Applicant's declaration
 NOTES: For question 7
Under section 371 of the Sustainable Planning Act 2009, if the
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:
                                                                                By making this request, I declare that all information in this
       relates to land the was acquisition land to which section
       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 o development
      application were mode 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.




Pp-OA-FM401/1-3010412010                                                                                                        Page 2 of 2