Change of existing approval Shop 3 OTT b254 · 132004.240098.4

“N

| If yes, please attach a copy of the notice.

  
    

3. Nature of request Me tick alee eS categories)

  

To change the development | O To change the development i io To extend the relevant period
approval i conditions i before lapsing

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

 

 

 

 

a of tha
UnitNo. 3 Street No 229-231 Street Gympie Terrace
Suburb Noosaville State Qld Postcode 4566
Lat ne. » Pen & aD.
toa SP188227

 

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

0 Yes-provide details below

Note — Under s372 of the Sustainable Planning Act 2009 the person making the request is required to give a copy of this request to all
concurrence agencies.

LTTE Tow TLS G 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?
NW No i 0 Yes

 

 

 

 

eae lta

 

Is the owner's consent required for this request? ONo

O Yes— complete either Table A or Table 8 below

 

 

 

 

Note — If more than one owner of the land all owners’ details are required

 

Table A= acl Ss a provided on uu pS B- Ce oS eu ec on form

Owner's name/s Lop fe Lee
Noosy Fawn TREE Hocomes EL

 

 

We, the above-mentioned owner/s of ne land, consent
to the making of this request, _,

 

 

Signature/s Bh CE, f- 2 |

 

 

Date (4 ANE

 

 

 

 

 

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