Minor Change Request (Planning Act 2016) 111 & 113 Gympie Terrace

Change application form
Planning Act Form 5 (version 1.0 effective 3 July 2017) made under Section 282 of the Planning Act 2016.
This form is to be used for a change an 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)       J & S Payne C/- ADAMS + SPARKES Town Planning
 Contact name (only applicable for companies)              Michael Lyell
 Postal address (P.O. Box or street address)               PO Box 1000
 Suburb                                                    BUDINA
 State                                                     QLD
 Postcode                                                  4575
 Country
 Email address (non-mandatory)                             [email protected]
 Mobile number (non-mandatory)
 Applicant’s reference number(s) (if applicable)           160401

 2) Owner’s consent - Is written consent of the owner required for this change application?
 Note: section 79(1)(b)(iii) 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 – proceed to 3) in Part 2



PART 2 – RESPONSIBLE ENTITY DETAILS
 3) Identify the responsible entity that will be assessing this change application
 Note: see section 78(3) of the Planning Act 2016
 Noosa Council


PART 3 – CHANGE DETAILS
 4) Provide details of the existing development approval subject to this change application
 Approval type                      Reference number                    Date issued                        Assessment
                                                                                                           manager/approval entity
    Development permit              MCU16/0138 &                                                           Noosa Council
                                                                        9 May 2017
    Preliminary approval            OPW16/0257
    Development permit
    Preliminary approval