Attachment F - DA Form 5 and Owner's Consent · 132008.1128.04

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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 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                                                                                      Noosa Council
                                     132008.1128.02                     28 March 2019
    Preliminary approval
    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 town planning 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




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

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PART 5 – MINOR CHANGE APPLICATION REQUIREMENTS

  7) Are there any affected entities for this change application
      No – 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 pre-
                                               request response notice for the application has been          request response provided)
                                               given, a copy of the notice must accompany this change
                                               application)
                                                    No
                                                    Yes – pre-request response is attached to
                                                    this change application
                                                   No
                                                   Yes – pre-request response is attached to
                                                   this change application
                                                    No
                                                    Yes – pre-request response is attached to
                                                    this change application

PART 6 – OTHER CHANGE APPLICATION REQUIREMENTS
Note: To complete this part it will be necessary for you to complete parts of DA Form 1 – Development application details and in some instances parts
of DA Form 2 – Building work details, as mentioned below. These forms are available at https://planning.dsdmip.qld.gov.au.


  8) Location details - Are there any additional premises included in this change application that were not part of the
     original development approval?
      No
      Yes

  9) Development details
  9.1) Is there any change to the type of development, approval type, or level of assessment in this change
       application?
      No
      Yes – the completed Sections 1 and 2 of Part 3 (Development details) of DA Form 1 – Development application
      details as these sections relate to the new or changed aspects of development are provided with this application.
  9.2) Does the change application involve building work?
      No
      Yes – the completed Part 5 (Building work details) of DA Form 2 – Building work details as it relates to the
      change application is provided with this application.

  10) Referral details – Does the change application require referral for any referral requirements?
  Note: The application must be referred to each referral agency triggered by the change application as if the change application was the original
        development application including the proposed change.
      No
      Yes – the completed Part 5 (Referral details) of DA Form 1 – Development application details as it relates to the
      change application is provided with this application. Where referral is required for matters relating to building
      work the Referral checklist for building work is also completed.

  11) Information request under Part 3 of the DA Rules
      I agree to receive an information request if determined necessary for this change application
      I do not agree to accept an information request for this change application
  Note: By not agreeing to accept an information request I, the applicant, acknowledge:


                                                                                                                                             Page 3
                                                                                                       Planning Act Form 5 - Change application form
                                                                                                                      Version 1.2 — 7 February 2020

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    that this change application will be assessed and decided based on the information provided when making this change application and the
     assessment manager and any referral agencies relevant to the change application are not obligated under the DA Rules to accept any
     additional information provided by the applicant for the change application unless agreed to by the relevant parties
  Part 3 of the DA Rules will still apply if the application is an application listed under section 11.3 of the DA Rules.
 Further advice about information requests is contained in the DA Forms Guide: Forms 1 and 2.


 12) Further details
     Part 7 of DA Form 1 – Development application details is completed as if the change application was a
     development application and is provided with this application.

PART 7 – CHECKLIST AND APPLICANT DECLARATION

 13) Change application checklist
 I have identified the:
  responsible entity in 4); and
  for a minor change, any affected entities; and                                                                         Yes
  for an other change all relevant referral requirement(s) in 10)
 Note: See the Planning Regulation 2017 for referral requirements
 For an other change application, the relevant sections of DA Form 1 – Development                                        Yes
 application details have been completed and is attached to this application                                              Not applicable
 For an other change application, where building work is associated with the change                                       Yes
 application, the relevant sections of DA Form 2 – Building work details have been
 completed and is attached to this application                                                                            Not applicable

 Supporting information addressing any applicable assessment benchmarks is attached to
 this application
 Note: This includes any templates provided under 23.6 and 23.7 of DA Form 1 – Development application details            Yes
 that are relevant as a result of the change application, a planning report and any technical reports required by the
 relevant categorising instrument(s) (e.g. the local government planning scheme, State Planning Policy, State
 Development Assessment Provisions). For further information, see DA Forms Guide: Planning report template.
 Relevant plans of the development are attached to this development application
 Note: Relevant plans are required to be submitted for all relevant aspects of this change application. For further       Yes
 information, see DA Forms Guide: Relevant plans.


 14) Applicant declaration
     By making this change application, I declare that all information in this change application is true and correct.
     Where an email address is provided in Part 1 of this form, I consent to receive future electronic communications
     from the responsible entity and any relevant affected entity or referral agency for the change application where
     written information is required or permitted pursuant to sections 11 and 12 of the Electronic Transactions
     Act 2001.
 Note: It is unlawful to intentionally provide false or misleading information.
 Privacy – Personal information collected in this form will be used by the responsible entity and/or chosen
 assessment manager, any relevant affected entity or referral agency and/or building certifier (including any
 professional advisers which may be engaged by those entities) while processing, assessing and deciding the
 change application.
 All information relating to this change application may be available for inspection and purchase, and/or published on
 the assessment manager’s and/or referral agency’s website.
 Personal information will not be disclosed for a purpose unrelated to the Planning Act 2016, Planning Regulation 2017
 and the DA Rules except where:
      such disclosure is in accordance with the provisions about public access to documents contained in the Planning
       Act 2016 and the Planning Regulation 2017, and the access rules made under the Planning Act 2016 and
       Planning Regulation 2017; or
      required by other legislation (including the Right to Information Act 2009); or
      otherwise required by law.
 This information may be stored in relevant databases. The information collected will be retained as required by the
 Public Records Act 2002.


                                                                                                                                              Page 4
                                                                                                        Planning Act Form 5 - Change application form
                                                                                                                       Version 1.2 — 7 February 2020

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PART 8 – FOR COMPLETION OF THE ASSESSMENT MANAGER – FOR OFFICE
USE ONLY

 Date received:                                   Reference number(s):

 QLeave notification and payment
 Note: For completion by assessment manager if applicable
 Description of the work
 QLeave project number
 Amount paid ($)                                                 Date paid (dd/mm/yy)
 Date receipted form sighted by assessment manager
 Name of officer who sighted the form




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

Page 6

Noosa Shire Council
PO Box 141
Tewantin QLD 4565

To whom it may concern,
RE: LANDOWNER CONSENT FOR DEVELOPMENT APPLICATION

The Uniting Church in Australia Property Trust (Q.) (A.B.N. 25 548 385 225) consents to the lodgement of
development application/s and/or change application/s by RPS Australia East Pty Ltd over land at:

At: Grasstree Court, Sunrise Beach QLD 4567
RPD: Lot 6 on RP901384 and Lot 9 on SP252905
Yours faithfully,

Me LG. [4/2019

Sign Date

TWART__ PLCKERING
Name

GENRRAL MAnAWeR PROPERTY _DEVEWTHENT

Position (e.g. Director / Secretary)

Sign Date

 

Name

 

Position (e.g. Director / Secretary)

The A.C.N. must be included and accompanied by —

e — the signature of either:
- two directors of the company;
-  adirector and a company secretary of the company; or
- _ ifa proprietary company that has a sole director who is also the sole company secretary, that director;
OR

* the company seal (if the company has a common seal) witnessed by:
— two directors of the company;
-  adirector and a company secretary of the company; or
— for a propriety company that has a sole director who is also the sole company secretary, that director.

If signing under a Power of Attorney, please provide a copy of the Power of Attorney documents.

Page 1

Page 7

CURRENT TITLE SEARCH

NATURAL RESOURCES, MINES AND ENERGY, QUEENSLAND
Request No: 32549652
Search Date: 08/11/2019 12:22 Title Reference: 50133929
Date Created: 24/07/1996
Previous Title: 50105932
REGISTERED OWNER

Dealing No: 714848618 18/12/2012

THE UNITING CHURCH IN AUSTRALIA PROPERTY TRUST (Q.)
A.B.N. 25 548 385 225

ESTATE AND LAND
Estate in Fee Simple

LOT 6 REGISTERED PLAN 901384
Local Government: NOOSA

EASEMENTS, ENCUMBRANCES AND INTERESTS

1. Rights and interests reserved to the Crown by
Deed of Grant No. 10777073 (POR 1653)

2. EASEMENT IN GROSS No 701044287 06/12/1995 at 11:22
burdening the land to
COUNCIL OF THE SHIRE OF NOOSA
over
EASEMENT C ON RP890947

3. COVENANT No 714848621 18/12/2012 at 15:10
SUNSHINE COAST REGIONAL COUNCIL

ADMINISTRATIVE ADVICES - NIL
UNREGISTERED DEALINGS - NIL

Caution - Charges do not necessarily appear in order of priority
** End of Current Title Search **

COPYRIGHT THE STATE OF QUEENSLAND (NATURAL RESOURCES, MINES AND ENERGY) [2019
Requested By: D-ENQ GLOBALX TERRAIN

Page 1/1

Page 8

CURRENT TITLE SEARCH
NATURAL RESOURCES, MINES AND ENERGY, QUEENSLAND
Request No: 32549697
Search Date: 08/11/2019 12:24 Title Reference: 50887149
Date Created: 26/07/2012

Previous Title: 50563517
REGISTERED OWNER
Dealing No: 714848618 18/12/2012

THE UNITING CHURCH IN AUSTRALIA PROPERTY TRUST (Q.)}
A.B.N. 25 548 385 225

ESTATE AND LAND
Estate in Fee Simple

LOT 9 SURVEY PLAN 252905
Local Government: NOOSA

EASEMENTS, ENCUMBRANCES AND INTERESTS

1. Rights and interests reserved to the Crown by
Deed of Grant No. 10777073 (POR 1653)

2. EASEMENT IN GROSS No 714585979 24/07/2012 at 16:12
burdening the land
NORTHERN SEQ DISTRIBUTOR-RETAILER AUTHORITY
over
EASEMENT T ON SP252905

3. EASEMENT IN GROSS No 714585981 24/07/2012 at 16:12
burdening the land
SUNSHINE COAST REGIONAL COUNCIL
over
EASEMENT U ON SP252905

4. COVENANT No 714848621 18/12/2012 at 15:10
SUNSHINE COAST REGIONAL COUNCIL

5. MORTGAGE No 719676540 15/10/2019 at 12:42
LENDLEASE RL FUTURE DEVELOPMENT NO 3 HOLDING PTY LTD A.B.N.
69 619 177 052

ADMINISTRATIVE ADVICES

Dealing Type Lodgement Date Status

713896624 VEG NOTICE 08/06/2011 15:07 CURRENT
VEGETATION MANAGEMENT ACT 1999

UNREGISTERED DEALINGS - NIL

Page 1/2

Page 9

CURRENT TITLE SEARCH

NATURAL RESOURCES, MINES AND ENERGY, QUEENSLAND
Request No: 32549697
Search Date: 08/11/2019 12:24 Title Reference: 50887149
Date Created: 26/07/2012
Caution - Charges do not necessarily appear in order of priority

** End of Current Title Search **

COPYRIGHT THE STATE OF QUEENSLAND (NATURAL RESOURCES, MINES AND ENERGY) [2019]
Requested By: D-ENQ GLOBALX TERRAIN

Page 2/2