DA20250050_DA Form 5 · 132010.574.01

        Postcode                        Lot No.                         Plan Type and Number (e.g.             Local Government
                                                                        RP, SP)                                Area(s)


 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)
                                                                                           WGS84
                                                                              54
                                                                                           GDA94
                                                                              55
                                                                              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
                                     132010.574                         31/05/2010                          Noosa Shire Council
     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):
Enclosure of an existing patio
 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