Laguna Villas 39 & 50 - Application For Change To Approval

Change application form

Planning Act Form 5 (version 1.1 effective 22 JUNE 2018) made under Section 282 of the Planning Act 2016.
This form is to be used for a change application made under section 78 of the Planning Act 2016. It is important
when making a change application to be aware of whether the application is for a minor change that will be
assessed under section 81 of the Planning Act 2016 or for an ‘other’ change that will be assessed under section 82
of the Planning Act 2016.

An applicant must complete all parts of this form, and Provide any supporting information that the form identifies as
being required to accompany the change application, unless stated otherwise. Additional pages may be attached if
there is insufficient space on the form to complete any part.

Note: All terms used in this form have the meaning given under the Planning Act 2016, the Planning Regulation 2017, or the
Development Assessment Rules (DA Rules).

PART 1 —APPLICANT DETAILS

Ss. or full name) A 4
Contact name (only applicable for companies) : Chae Willa

Postal address (P.0. Box or street address) 14 ivi
Suburb

State

Postcode

Email address
Mobile number

es — the written consent of the owner(s) is attached to this change application

(J) No

 

 

PART 2 —LOCATION DETAILS

; lot on plan (ail jots must be listed), or
Street address AND lot on plan for an adjoining or adjacent property of the premises {appropriate for development in
e al

water
Street No. and T) Suburb

LALAS M1

a No. Plan T Number (e.g. RP, Local Government

Unit No. Street No. Street Name and T. Suburb

Postcode Lot No. Plan Type and Number (e.g. RP, Local Government

Local Government

   

2p Queensland
" Government