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Planning Act Form 5 (002)
Easting(s) Northing(s) Zone Ref. Datum Local Government Area(s) (if applicable)
L154 LJ wGS84
{] 55 ] GDA94
L] 56 [J Other:
3.3) Additional premises
{J Additional premises relevant to the original development approval and their details 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
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
| [.] Preliminary approval
(J Development permit
(] Preliminary approval
22803 DA 14 August 2003 Noosa Council
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):
Emergency Bushfire Clearing
6.2) What type of change does this application propose?
MM 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
we = proceed to Part 7
Yes — list all affected entities below and proceed to Part 7
Note; section 80(1) of the Planning Act 2016 states that the person making the change application must give notice of the proposal
and the details of the change to each affected entity as identified in section 80(2) of the Planning Act 2016.
Affected entity Pre-request response provided? (where a pre- | Date notice given (where no
request response notice for the application has | pre-request response
been given, a copy of the notice must provided)
acgompany this change application)
Assessment Manager M No 12/09/2019
(Conor Neville) LJ Yes — pre-request response is attached to
this change application
L] No
CJ Yes — pre-request response is attached to
this change application
LI No
L] Yes — pre-request response is attached to
this change application
Page 2
Planning Act Form § - Change application form
Version 1.4 — 22 JUNE 2018
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