Planning Act Form 5_.pdf

  	
  




  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
1) Applicant details
Applicant name(s) (individual or company full name)                   T, Rossiter, A, Rossiter, S, Murphy & S, Sales
Contact name (only applicable for companies)                          C/- Noosa Town Planning (Callie Brennan)
Postal address (P.O. Box or street address)                           42 Gympie Street
Suburb                                                                Tewantin
State                                                                 QLD
Postcode                                                              4565
Country
Email address (non-mandatory)                                         [email protected]
Mobile number (non-mandatory)                                         0473355912
Applicant’s reference number(s) (if applicable)

2) Owner’s consent - Is written consent of the owner required for this change application?
Note: section 79(1A) of the Planning Act 2016 states the requirements in relation to owner’s consent.
         Yes – the written consent of the owner(s) is attached to this change application
         No


  PART 2 – LOCATION DETAILS

3) Location of the premises (complete 3.1) or 3.2), and 3.3) as applicable)
3.1) Street address and lot on plan
   Street address AND lot on plan (all lots must be listed), or
   Street address AND lot on plan for an adjoining or adjacent property of the premises (appropriate for development in
water but adjoining or adjacent to land e.g. jetty, pontoon; all lots must be listed).
            Unit No.        Street No.           Street Name and Type                                  Suburb
                            11                   Opal Street                                           Cooroy
a)
            Postcode        Lot No.              Plan Type and Number (e.g. RP, SP)                    Local Government Area(s)
                            1                    SP248165                                              Noosa
            Unit No.        Street No.           Street Name and Type                                  Suburb
b)
            Postcode        Lot No.              Plan Type and Number (e.g. RP, SP)                    Local Government 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. Only one set of coordinates is required for this part.
   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




  	
  


[OCR of page images]
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

1) Applicant details

 

 

 

 

 

 

 

 

 

Applicant name(s) (individual or company full name) T, Rossiter, A, Rossiter, S, Murphy & S, Sales
Contact name (only applicable for companies) C/- Noosa Town Planning (Callie Brennan)
Postal address (P.O. Box or street address) 42 Gympie Street

Suburb Tewantin

State QLD

Postcode 4565

Country

Email address (non-mandatory) [email protected]

Mobile number (non-mandatory) 0473355912

Applicant's reference number(s) (if applicable)

 

 

2) Owner's consent - Is written consent of the owner required for this change application?
Note: section 79(1A) of the Planning Act 2016 states the requirements in relation to owner’s consent.
L] Yes — the written consent of the owner(s) is attached to this change application

XX] No

 

 

 

 

PART 2 — LOCATION DETAILS

Street address AND lot on plan (all Jots must be listed), or

Street address AND lot on plan for an adjoining or adjacent property of the premises (appropriate for development in
water but adjoining or adjacent to land e.g. jetty, toon; all lots must be listed).

Unit No. Street No. Street Name and T' Suburb
11 Opal Street Cooro

Postcode Lot No. Plan Type and Number (e.g. RP, SP) Local Government Area(s
1 SP248165 Noosa

Unit No. Street No. Street Name and T' Suburb

a)

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

Coordinates of premises by longitude and latitude
Longitude(s) Latitude(s) Datum Local Government Area(s) (if applicable)
WGS84
LJ GDA94
L] Other:
Coordinates of premises by easting and northin

 

PREy Queensland