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CDC No: …………………………........

PO 7064 Baulkham Hills BC NSW 2153


3 Columbia Court Baulkham Hills NSW 2153
Fee: …………………………………
9843 0431 Receipt No: …………………………………
ask@hillscertifiers.com.au Date: / /
www.hillscertifiers.com.au
Cust Service: ………………………………..
A business initiative of the Hills Shire Council

Application to MODIFY a COMPLYING DEVELOPMENT CERTIFICATE


Section 87 of the Environmental Planning & Assessment Act 1979

Note – all pages of the relevant Self Assessment Checklist are to be completed and attached

1. Details of Complying Development Certificate to be modified


Approved Complying Value of proposed
Development Certificate No. modification
Description of proposed
modification

2. Property Details
Lot/DP/SP etc
Property address

3. Applicant details
Full name or company ABN:
Company contact person
Postal address

Contact Details phone: mobile:


email: fax:

Signature Date: / /

4. Owner details As above otherwise please provide details below

Full name or company ABN:


Company contact person
Postal address

Contact Details phone: mobile:


email: fax:

Signature Date: / /

Last updated 4/2/14

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