Change Application - Completed · MCU18/0013.01

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Department of Infrastructure, Local Government and Planning

 

5) Type of change proposed

    

. ea Drie! Cl g

Sunit apartment building to provide for a6 unit apartment bui ;
Crimea? TO Ce Pima 6. oe APR ate - VOr Ramm bis
wo rious Des Esoestic Sescie Gevnoe Greeti SeGosh
pa Cterass re estat i mG ST CenAsTieW. ec Ctesgscs—
5.2) What type of change does this application propose?
mM Minor change application — proceed to Part 4
(1 Other change application — proceed to Part 5

 

 

 

 

 

 

PART 4— MINOR CHANGE APPLICATION REQUIREMENTS

 
    
 

ust give notice of the. proposal and

 

Affected entity - re f : jen (where no pre-
: request response provided)

 

CNo
(4 Yes — pre-request response is attached to
this change application

CINo

(1 Yes — pre-request response is attached to
this change application

[No

oO Yes — pre-request response is attached to
this change application

 

 

 

 

 

 

 

PART 5 — OTHER CHANGE APPLICATION REQUIREMENTS

Note: to complete this part it will be necessary for you to complete parts of DA Form 1 and in some instances parts of DA Form 2, as
mentioned below. These forms are available at www.dilgp.qid.gov.au.

7) Location details - Are there any additional premises included in this change application that were not part of the original
development approva

O

(Yes + complete Part 2 (Location deta
provided with this application.

 

8) Development details

 

re Does the change applica

LINo “

LJ Yes — the completed Part 5 (Building work details) of DA Form 2 as it relates to the change application is provided with
this application.

 

 

 

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Planning Act Form 5 - Change application form
Version 1.0—3 July 2017

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Department of infrastructure, Local Government and Planning

ates fo the change application is
ork the referral checklist for

 

 

 

 

 

 

 
    
  
 
    

OYes

 

O1 Yes
erNtot applicable

For an ‘other change application, where buildi rk 1S: ass i ang C1 Yes

application, the relevan
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) of DA Form 1 that are relevant as a

result of the change application, a planning report and any technical reports required by the C1 Yes
relevant categorising instrum int(s) (e.g. thé local government planning scheme, State Planning

Policy, State Development A. ment Provisions). For further information, see DA Forms

 

 

 

Relevant plans of the development are attached to this development application im
Yes

Note: Relevant plans are required to be submitted for all relevant aspects of this: change
application. For further information, see DA Forms Guide: Relevant plans.

 

Where an 1 email address is provided in Part 4 of this form, | 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 ard 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 application form
Version 1.0—3 July 2017

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Department of Infrastructure, Local Government and Planning

 

Privacy — Personal information collected i in this form will be used by the responsible entity and/or. chosen assessment
manager, any relevant af y or referral agency and/or: buildin y pro sional advisers which
maybe engaged by those entities) while processing, assessing and deciding the change app cation.
All information relating to this chanc application may be available for inspection and purchase, and/or published on the
assessment manager's and/or ret ie website.
Personal information wil 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 r
2016 and. the Planning Re
Regulation: 2017; or
e -required by other legi
° 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.

PART 7 — FOR OFFICE USE ONLY

Date received: fd] Reference number(s): |

ORES Oe and aul

    
 

  
 

 

 

     
 

cess to. documents contained in the Planning Act

with the provisioris about public
de under the Planning Act 2016 and Planning

ation 2017, and. the access rules

  

ion (including the Right: to Information Act 2009); or

 

  

 

 

 

 

 

 

QLeave project number
Amount paid ($) /
Date ald /

 

 

 

 

 

 

 

 

 

The Planning Act 2016, the Planning Regulation 2017 and the DA Rules are administered by the Department of
Infrastructure, Local Government and Planning. This form and ail other required change application materials should be

sent to the responsible entity.

Page 4
Planning Act Form 5 - Change application form
Version 1.0—3 July 2017