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* Full name:

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* If organisation, contact person:

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* Full postal address:

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* Address for service: (if different from above)

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* Phone number(s):

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* Fax:

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* Email:

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* In accordance with clause 8(1)(b) of the First Schedule of the RMA:

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* and my reason(s) are:

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* Do you wish to speak at the hearing?

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* If others make a similar submission would you be prepared to consider a joint case?

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