Form5-Change Application

          Unit No.       Street No.       Street Name and Type                                    Suburb
                         71               Hastings Street                                         Noosa Heads
   c)
          Postcode       Lot No.          Plan Type and Number (e.g. RP, SP)                      Local Government Area(s)
          4567           56               SP178320                                                Noosa Shire Council
          Unit No.       Street No.       Street Name and Type                                    Suburb
                         71               Hastings Street                                         Noosa Heads
  d)
          Postcode       Lot No.          Plan Type and Number (e.g. RP, SP)                      Local Government Area(s)
          4567           57               SP266734                                                Noosa Shire Council
 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)
                                                      54            WGS84
                                                      55            GDA94
                                                      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




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                                                                                                  Planning Act Form 5 - Change application form
                                                                                                                 Version 1.2 — 7 February 2020