D10/25115 RC-05_Affected Person(s) Written Approval
I have read the full application for resource consent, the Assessment of Environmental Effects, and
any site plans as follows:
(list any other document names and dates if not listed)
scription of Activity
sessment of Effects
(Tick boxes to show attachments with this consent)
In signing this written approval, I understand that the consent authority must decide that I am no
longer an affected person, and the consent authority must not have regard to any adverse effects
I understand that I may withdraw my written approval by giving written notice to the consent
authority before the hearing, if there is one, or, if there is not, before the application is determined.
(Person giving approval or authorised agent)
(Name and Designation, if applicable)
NOTES TO AFFECTED PERSON SIGNING WRITTEN APPROVAL:
1. Conditional written approvals cannot be accepted.
2. There is no obligation to sign this form, and no reasons nee
d to be given.
If this form is not signed, the application may be notified with an opportunity for submissions.
If signing on behalf of a trust or company, please provide additional writte
n evidence that you have
Should you have any concerns regarding this proposal then please do not hesitate to contact
Phone: (06) 765 6099 24 hours
Office: 61 - 63 Miranda Street, Stratford
Postal: PO Box 320, Stratford 4352
Hours: Monday - Friday 8.30am - 4.30pm