DA Form 5

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    3.2) Coordinates of premises (appropriate for development in remote areas, over part of a lot or in water not adjoining or adjacent to land e.g.
         channel dredging in Moreton Bay)
    Note: Place each set of coordinates in a separate row.
    ☐ Coordinates of premises by longitude and latitude
    Longitude(s)                     Latitude(s)                     Datum                          Local Government Area(s) (if applicable)
                                                                     ☐ WGS84
                                                                     ☐ GDA94
                                                                     ☐ Other:
    ☐ Coordinates of premises by easting and northing
    Easting(s)               Northing(s)              Zone Ref.      Datum                          Local Government Area(s) (if applicable)
                                                      ☐ 54           ☐ WGS84
                                                      ☐ 55           ☐ GDA94
                                                      ☐ 56           ☐ Other:
    3.3) Additional premises
    ☐ Additional premises are relevant to the original development approval and the details of these premises have been
      attached in a schedule to this application
    ☒ Not required


PART 3 – RESPONSIBLE ENTITY DETAILS
    4) Identify the responsible entity that will be assessing this change application
    Note: see section 78(3) of the Planning Act 2016
    Noosa Shire Council


PART 4 – CHANGE DETAILS
    5) Provide details of the existing development approval subject to this change application
    Approval type                        Reference number                   Date issued                         Assessment
                                                                                                                manager/approval entity
    ☒ Development permit                 MCU18/0008 and                                                         Noosa Council
                                                                            18/05/18
    ☐ Preliminary approval               OPW18/0013
    ☐ Development permit
    ☐ Preliminary approval

    6) Type of change proposed
    6.1) Provide a brief description of the changes proposed to the development approval (e.g. changing a development
         approval for a five unit apartment building to provide for a six unit apartment building):
    Refer to cover letter.

    6.2) What type of change does this application propose?
    ☒ Minor change application – proceed to Part 5
    ☐ Other change application – proceed to Part 6


PART 5 – MINOR CHANGE APPLICATION REQUIREMENTS

    7) Are there any affected entities for this change application
    ☒ No – proceed to Part 7

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                                                                                                      Planning Act Form 5 - Change application form
​                                                                                         ​                                         ​       Version
                                                                                                                             1.2 — 7 February 2020