Council archive · source document
Changes Application Form - TPC 2563 - Adding Sun Room - 1/2 La Maison Neptune Circuit Noosaville · 51993.587.04
D .,~ I I • '-'
+ nunter
30 JAN 7018
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Department of Infrastrudure.local Government and Planning
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Changeapplicationform~--::===---=::J
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Planning Act Form 5 lV81'S/on 1.0 eflectJve 3 July 201T} made under Section 282 of the Planning Act 2016.
This foon is to be used for a change" an application made under section 78 of the Planning Act 2016. II is important when
making a change application to be aware of whether the application is for a minor change that win 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 Acf
2016.
An appticant must complete all parts of this form. and provide any supporting information that the form identifies as being
requirad to accompany the change application, unless stated otherwise. Add~ional pages may be attached if there is
insuflicient space on the form to complete any part.
Note: A//tetmS used in this fonn have the meaning given under the Planning Acl 2016, the Planning Regula~on 2017, or the Development
Assessment Rules (DA Rules).
PART 1 -APPLICANT DETAILS
11Appl.'_dfl' oetmls
App/ican1 name(s) (1ncfvkIuaI or """PJI1Y full name)
Contact name (only eppIIcabIe
forCOlfJ"/l1les)
Postal address (p.O. Boxor __ so)
Suburb
State
Postcode
Country
Email address (nort-mendatoly)
Mobile number (non-mandBIoty)
AppflC3nt's reference number(s) (ifBPPIicable)
Yes - the written consent of the owner(s) is attached to this change application
o No - proceed to 3) in Part 2
PART 2 - RESPONSIBLE ENTITY DETAILS
311delll,fy II", re"pul15lhle entity IImt ",II be assess,ng thiS change application
Note ',r-P .sP.-I, " -rl' . I' ':' ;';';1' /)"'(} A( t .-'01{;
PART 3 - CHANGE DETAILS
..:..~I _'.Ide details of the eX1stlr:g development appro\ al suuJect to thiS cthmge applicatIon
Approval type Reference number Date issued Assessment
manager/approval entity
ijJ Development penni!
o Preliminary approval S\9'13.,S~1
o Development penn~ C 1PC?SU)
o Preliminary approval
Box' .3//0 &.
.............................. R: . Queensland
Government
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Page 2
Departmentof Infrastructure. local Governmentand Pla;,"ln
5, T'ip8 of CY'rlr.gl'; proposeo
5.1) Provide a brief description of the changes proposed to the development approval (e.g.chengIng e de>,'''1''''''' ~ for.
5 unn epettment ~ 10 pt'lWIde
for e 6 untr~ build"mg):
A f:::,D I r-i CA P\SVvJ ~ <:> "'.--......
5.2) What type of change does this application propose?
E1Minor change application - proceed to Part 4
o Other change application - proceed to Part 5
PART 4 - MINOR CHANGE APPLICATION REQUIREMENTS
61 Are there rJnj ~ffected entitles for thiS change application
0110 - proceed to Part 6
DYes - rlStan affected entities below and proceed to Part 6
'No"': section 80(1) of/he Pfanning Act 2016 states that the person malcing tha change application mus/give noIJceoftha propose/and
tha dewNs of /he change 10 each affected entfty as identified in sectJon 80(2) of the Plann/ng Act 2016.
Affected entity Pre-request response provided? (wIlere a pre- Date notice given (wIlere no pre-
request response notice for the application has request response provided)
been given, a copy of the notice must
accompany this change application)
oNo
DYes - pre-request response is attached to
this change application
oNo
DYes - pre-request response is attached to
this change application
oNo
DYes - pre-request response is attached to
this change application
PART 5 - OTHER CHANGE APPLICATION REQUIREMENTS
Note: 10 complete this part /I will be necessary for you to comp/ele parts of VA Form 1 and in some Instancesparts of VA Form 2, as
mantioned below. These forms a19available al www.di!qp.qld.ggv.au.
71 ! O(cltmn (1Ptd'ls - A'-~ ~:'ere ;my (lddlt!orlai pre'" IS~S'nduded In th:s change a;3pl1cahon that : •.er~ ! ,r:! par': :,f th8 onJlnal
(jf'veloprnenl ap,Y:Jv-1P
oNo
DYes - complete Part 2 (Location details) of DA Fonn 1as it relates to the additional premises is completed and
provided with this application.
F<•. n~.03101 H'I1('nl d0'"JlS
[:. Arf' Ihf>re :'lrry ne.', or ,-h;.lngf'd developm(~nt ClSPP( ts Included In IhlS c!'anqe Zlpplfcatton that ,1r.:::'1::"J' l1;;1rlof tile
(Jf ;j>11ill (1f .•••eloVrnent approvi'tP
o No - proceed to 9)
DYes - the completed Sections 1 and 2 of Part 3 (Development details) of DA Fonn 1 as these sections relate to the
new or changed aspects of development are provided with this application.
82) :>:"t;'; t...,~cr,al',ge a~j)llcatlon Involve bUlldl!lg work?
oNo
DYes - the completed Part 5 (Building wor!( details) of DA Fonn 2 as It relates to the change application is provided with
this application.
Page 2
Plarv1ing
Ad Foon5 • Changeapplicationloon
Vel1llon1.()~ July2017
Page 3
-------- ---------------------- -------
Departmentof Infrastructure, LocalGovernmentand Planr
91 Referral deta'is • Do any ilspects of the change application reqUire referral lor any reterral reqUirements?
Note lilt- J/,pIILllld, /nil'" [)t.. 'd"'U(-f(1 to t",/(/) fl;:!t''',I! d!<IIIl}i::' ,lp'Jlll.-dtl,11I .~d, lilt, 0 "l,ndl
dyt.'llt.~ t!l(j~t.'l'tllJy t'lt' U/'/Ili}t:! d/Jphcd!JUfJ ,1:;." 111/1
.If'~l.I{,,r(''f'fd ,IP/,II.-,II HI m(/o<ll/lI:1 flit' "'vpGspd cli.II 'g!'
oNo
o Ves - the completed Sections 1 and 2 of Part 5 (Referral details) of DA Form 1 as it relates to the change application is
provided with this application. Where referral is required for matters relating to building wor!<the referral checklist for
building wor!< is also completed.
1011"lulilldliufI H;quest under I-'arl J 01 the lJA Rules
o I agree to receive an information request if determined necessary for this change application
o I do not agree to accept an information request for this change application
Note: By not agreaing to acoopt an information request I. the applicant, acknowladge:
• that this changa application will be assessed and decided besed on the Information provided when making this change application
and tha assassment manager and any referral egencias relevant to the chenge epplication ere not obllgatad under tha DA Rules to
accept any additional information provided by tha appllcanl for the change application unless agreed to by the relevant partias
• Part 3 of the DA Rules will stilt apply if the application is en application listed under section 11.3 oftha DA Rules.
Further advice about information requests is contained in tha DA Forms Guide.
D Part 7 of DA Form 1 is completed as if the change application was a development application and is provided with this
application.
PART 6 - CHECKLIST AND APPLICANT DECLARATION
12) cil"f1ye applj{'~tiOl1 Checklist
I have identified the:
• responsible entity In 3); and
• for a minor change. any affected entities; and []-Yes
• for an 'other' change ali relevant referral requlrement(s) In 9)
Nole: See the Planning Regulation 2017 for referral requirements
For an 'other' change application, the relevant sections of DA Form 1 - Development DVes
details have been completed and Is attached to this application D Not applicable
For an 'other' change application. where building work is associated with the change
DVes
application. the relevant sections of Form 2 - Building work details have been
D Not applicable
completed and is attached to this application
Supporting information addressing any applicable assessment benchmar!<s Is attached
to this application
Note: This Includes any templates provided under 23.6) of DA Form 1 that are relevant as a
resun of the change application. a planning report and any technical reports required by the rrYes
relevent cetegorising instrument(s} (e.g. the local government planning scheme, State Planning
Policy, State Development Assessment Provisions). For further information. see DA Eonus
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 [;}Yes
application. For further information, see DA Forms Guide: Relevant plans.
LJ ~ making this change application. I declare that all Information in this change application Is true and correct.
ITWhere an email address is provided In Part 1 of this form, I consent to receive future electronic communications from
the responsible entity and any relevan! 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.
Page 3
Planning Act Form 5 - Change appllcatlon fann
Version U)-~ July 2017
Page 4
Department oflnlrastlUclure. local Government and Planning
Privacy _ Personal infonnation collected in this foon will be used by the responsible entity and/or chosen assessment
manager, any relevant affected entity or refenal agency and/or building certlfler (including any professional advisers which
may be engaged by those entities) while processing, assessing and deciding the change application.
All infonnation 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 webslle.
Personal infoonation wiD not be disclosed for a purpose unrelated to the Planning Act 2016, Planning Ragulation 2017 and
the DA Rules except where:
• such disclosure is in acoordance 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 infonnation may be stored in relevant databases. The Infonnation collected will be retained as required by the Public
Records Act 2002.
PART 7 - FOR OFFICE USE ONLY
Date received: ~ I Reference number(s):
OleE1v(. nol.flC.atlorl and payment
N,J" F,'" ,d'i
, •• ,,~"l s:,.n "Iii,' , IJ' •• If I' "/,,,\
Description of the wof1<
QLeave project number
Amount paid ($)
Date paid
Date receipted foon sighted by assessment manager
Name of officer who sighted the fonn
The Planning Act 2016. the Planning Regulation 2017 and the DA Rules are administered by the Department of
Infrastructure, Local Government and Planning. This fonn and all other required change application materials should be
sent to the responsible entity.
Page 4
Planning Act Form 5 • Change eppllcation form
Version 1.G-3 July 2017
Page 5
1
o SHEET NUMBER
1
SHEET TITLE
SI1e plan
2 Existing Lower Floor
Plan
3 Proposed Floor Plan
4
------- '- EI';;:t~~ns
10
20 Work Place Health &
Safety Notes
NORTH
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Real Property Description
LoINo.1 on BUP.100427
Parish: Weyba
County: March
LoeaJity: Noosav~le
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My Aherations 10 \tie desi;ln or substitution of structural mernbef'i
!rom approved design plans wiltl oul tI1e written consent Irom
Sleven Hom Accolade &iIding Des~ns
WIUvoid any responsibilrties we have lor the
Address: 1f.2 Neptune Circun. Site Plan stnJctural integrity or perlormance of the building
THESE DRAWING ARE SUaJECTTO COPYRIGHT NO PART MAYBE
1 : 200 COPIED OR REPRODUCED OTHER THAN FOR THE PURPOSE OF THIS
CONSTRUCTION WITHOUT WRITIEN CONSENT FROM STEVEN HORN.
ACCOLADE BUILDING DESIG"l & DRAFTING
Client: 1/2 La Maison, Neptune Circuit Noosaville Wind Classification N3 Mobile: 0407 693 01 B
RPD: Loll on SUP 100427 Parish: Weyba
ACCOLADE Building Designs Dale 29I0112OIe8:33:.2 AM
County: March Email: [email protected] Drawn t>y; S.Hom DrilWl1 lor A3 SheEl!
Proprietor: Steven Horn
PrqectNumbef Q116..•
Proposed Additions to Existing Residence OSSA Lie. 54806 Issue Date: Issue Date Scale 1:200 Sheet No.1 0/.
Page 6
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Not for construction or certification
Client: 1/2 La Maison, Neptune Circuit Noosaville Wind Classification N3 Date 29,101120188:33;42 AM
ACCOLADE Building Designs
RPD: Lot 1 on SUP 100427 Parish: Weyba County: March Proprietor: Steven Horn Mobile: 0407 693 018
Proposed Additions to Existing Residence Email: [email protected]
Page 7
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Not for construction or certification
Client 1/2 La Maison, Neptune Circuit Noosaville Wind Classification N3 Dalll 29101120188:33:42 AM
ACCOLADE Building Designs
RPO: Lot 1 on SUP 100427 Parish:Weyba County: March Proprietor: Steven Horn Mobile:0407 693 018
Proposed Additions to Existing Residence Email: [email protected]
Page 8
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Northeast Elevation Southwest Elevation
1 : 100 1 : 100
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o Southeast Elevation
1 : 100
Not for construction or certification
Client: 1/2 La Maison, Neptune Circuit Noosaville Wind Classification N3 Dale 29I01t201E18:33;<13AM
ACCOLADE Building Designs
RPD: Lot 1 on BUP 100427 Parish: Weyba County: March Proprietor: Steven Horn Mobile: 0407 693 018 DraWl for A3 Sheet
Proposed Additions to Existing Residence Email: [email protected] Scaltl 1 :'00 Sl\eetNo.4 of.
Used in these records
Changes Application Form - TPC 2563 - Adding Sun Room - 1/2 La Maison Neptune Circuit NoosavilleRelated documentApplication case desk ↗
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