Council archive · source document
Change to Building Envelope - 152004.240041.4
06\ \s-D-co-r. d4004
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) NC.. 0 c_- 0 top,‘ NA
Contact name (only applicable for companies)
Postal address (P.O. Box or street address) P 0 &o.g I q 4 cookel
Suburb Q)LCACX rk0L) 01.Rx TO
State a.
Postcode 4E4,-3
Country ,riu-s-Cir)44,\IA _n ,
Email address (non-mandatory) 114Clr C-0 1' 1/4 QINk-• .)6 04K2 VA e.... 0--O'Nk .. 0.0
Mobile number (non-mandatory) c1,14.00‘ 00-, ott..
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
g 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
FA Street address AND lot on plan (all lots must be listed), or .
Li Street address AND lot on plan for an adjoining or adjacent property of the premises (appropriate for development in
water but adjoining or ad'acent to land e.g. jetty, pontoon; all lots must be listed).
Unit No. Street No. Street Name and Type Suburb
a)
-0,-S,.. GW'slopS; 'DRIVE (6i.AC-Nk 4)A030.)JrPtuJ
Postcode Lot No. Plan Type and Number (e.g. RP, SP) Local Government Area(s)
li- Pai4,.t5c,1 -
QUosq Shac-
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 .
Li Coordinates of premises by longitude and latitude
Lon•itude(s) Latitude(s) Datum Local Government Area(s) (if applicable)
LI WGS84
GDA94
LI Other:
LI Coordinates of premises by easting and northing mr '3 -2- R: ‘^-
Queensland
Government
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Page 2
Fasting(s) Northings) Zone Ref. Datum Local Government Area(s) (if applicable)
L54 El WGS84
El 55 GDA94
L56 El Other:
3.3) Additional premises
El Additional premises relevant to the original development approval and their details have been attached in a
schedule to this application
El 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 Plannin • Act 2016
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
II Development permit
ai Preliminary approval \ .S)- )c• k+ ' .2o'-i-)
El Development permit
El Preliminary approval
6) Type of change proposed
6.1) Provide a brief description of the changes proposed to the development approval (e.g. changing a development approval
for a five unit apartment building to provide for a six unit apartment building):
rt3 412A 0,0t'S ae... S'N n loo'
6.2) What type of change does this application propose?
El Minor change application — proceed to Part 5
El Other change application — proceed to Part 6
PART 5- MINOR CHANGE APPLICATION REQUIREMENTS
7) Are there any affected entities for this change application
n No — proceed to Part 7
El Yes — list all affected entities below and proceed to Part 7
Note: section 80(1) of the Planning Act 2016 states that the person making the change application must give notice of the proposal
and the details of the change to each affected entity as identified in section 80(2) of the Planning Act 2016.
Affected entity Pre-request response provided? (where a pre- Date notice given (where no
request response notice for the application has pre-request response
been given, a copy of the notice must provided)
accompany this change application)
No
El Yes — pre-request response is attached to
this change application
No
El Yes — pre-request response is attached to
this change application
El No
El Yes — pre-request response is attached to
this change application
Page 2
Planning Act Form 5 - Change application form
Version 1.1 —22 JUNE 2018
Page 3
PART 6- 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 https://planning.dsdrinip.q1d.gov.au
8) Location details - Are there any additional premises included in this change application that were not part of the
original development approval?
lEa No
▪ Yes — complete Part 2 (Location details) of DA Form 1 as it relates to the additional premises is completed and
•rovided with this a• •lication.
9) Development details
9.1) Is there any change to the type of development, approval type, or level of assessment in this change application?
RA No — proceed to 11)
Al Yes — the completed Sections 1 and 2 of Part 3 (Development details) of DA Form 1 as these sections relate to
the new or chan ed as• ects of develo•ment are rovided
• with this a• slication.
9.2) Does the change application involve building work?
• No
IEI Yes — the completed Part 5 (Building work details) of DA Form 2 as it relates to the change application is provided
with this application.
10) Referral details — Does the change application require referral for any referral requirements?
Note: The application must be referred to each referral agency triggered by the change application as if the change application was the original
development application including the proposed change.
E No
Lii Yes — the completed 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 work the Referral checklist for building work
is also completed.
11) Information request under Part 3 of the DA Rules
E I agree to receive an information request if determined necessary for this change application
• I do not agree to accept an information request for this change application
Note: By not agreeing to accept an information request I, the applicant, acknowledge:
that this change application will be assessed and decided based on the information provided when making this change application
and the assessment manager and any referral agencies relevant to the change application are not obligated under the DA Rules to
accept any additional information provided by the applicant for the change application unless agreed to by the relevant parties
Part 3 of the DA Rules will still apply if the application is an application listed under section 11.3 of the DA Rules.
Further advice about information re uests is contained in the DA Forms Guide: Forms 1 and 2.
12) Further details
E Part 7 of DA Form 1 is completed as if the change application was a development application and is provided with
this application.
PART 7- CHECKLIST AND APPLICANT DECLARATION
13 chan.e a..lication checklist
I have identified the:
responsible entity in 4); and
for a minor change, any affected entities; and LA Yes
for an 'other' change all relevant referral requirement(s) in 10)
Note: See the Planning Regulation 2017 for referral requirements
For an 'other' change application, the relevant sections of DA Form 1 —
Development application details have been completed and is attached to this LII Yes
M'Not applicable
application
For an 'other' change application, where building work is associated with the
['Yes
change application, the relevant sections of DA Form 2 — Building work details
have been completed and is attached to this application LI Not applicable
Supporting information addressing any applicable assessment benchmarks is
V'Yes
attached to this application
Page 3
Planning Act Form 5 - Change application form
Version 1.1 —22 JUNE 2018
Page 4
Note: This includes any templates provided under 23.6 and 23.7 of DA Form 1 that are
relevant as a result of the change application, a planning report and any technical
reports required by the relevant categorising instrument(s) (e.g. the local government
planning scheme, State Planning Policy, State Development Assessment Provisions).
For further information, see DA Forms Guide: Planning report template.
Relevant plans of the development are attached to this development
application
12/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,
14) Applicant declaration
By making this change application, I declare that all information in this change application is true and correct.
gWhere an email address is provided in Part 1 of this form, I 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 and 12 of the Electronic Transactions Act 2001.
Note: It is unlawful to intentionally provide false or misleading information.
Privacy — personal information collected in this form will be used by the responsible entity and/or chosen assessment
manager, any relevant affected entity or referral agency and/or building certifier (including any professional advisers
which may be engaged by those entities) while processing, assessing and deciding the change application.
All information 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 website.
Personal information will 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 accordance 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 information may be stored in relevant databases. The information collected will be retained as required by the
Public Records Act 2002.
PART 8 - FOR OFFICE USE ONLY
Date Reference number(s):
received:
QLeave notification and payment
Note: For completion by assessment manager if applicable
Description of the work
QLeave project number
Amount paid ($)
Date paid
Date receipted form sighted by assessment
manager
Name of officer who sighted the form
Page 4
Planning Act Form 5 - Change application form
Version 1.1 —22 JUNE 2018
Page 5
26. Jul. 2016 14:25 No. 1752 P. 16/27
CURRENTTITLESEARCH
DEPT OF NATURAL RESOURCES AND MINES, QUEENSLAND
Request No: 23897819
Seareh Date: 26/07/2016 13:28 Title Reference: S0892139
Date Created: 21/09/2012
Previous Title: 80698601
REGISTERED OWNER Interest
Dealing No: 714561664 11/07/2012
ROBERTS BROS HOLDINGS PTY LTD A.C.N. 010 473 864
TRUSTEE 1/2
UNDER INSTRUMENT 713140689
ROBERTS EROS HOLDINGS PTY LTD A.C.N. 010 473 864
TRUSTEE 1/2
UNDER INSTRUMENT 713140689
AS TENANTS IN COMMON
ESTATE AND LAND
2state in Fee Simple
LOT 4 SUktVEY PLAN 241367
Local Government: NOOSA
EASEMENTS, ENCUMBRANCES AND INTERESTS
1. Rights and interests reserved to the Crown by
Deed of Grant No, 11748176 (POE 271)
Deed of Grant No. 12029021 (POP. 273)
2. EASEMENT IN GROSS No 714561750 11/07/2012 at 10:24
burdening the land '
SUNSHINE COAST REGIONAL* COUNCIL
over
EASEMENT G ON 52241367
ADMINISTRATIVE ADVICES - NIL
UNREGISTERED DEALINGS - NIL
cERTIV/CATE OF TITLE ISSUED - Yes 21/09/2012 714561778 certificate No. 1
Caution - Charges do not necesearily appear in order (;) priority
** End of Current Title Search **
COPYRIGHT THE STATE OF QUEENSLAND (DEPT OF NATURAL RESOURCES AND MINES) [2016]
Requested By: D-ENQ CREDIT WORNS AUSTRALIA
Page 1/1
Page 6
8
RP903374
12
RP896928
1
nima
MAX WATTERSON
RP141330
Cov F +ASSOCIATES
CONSULTING SURVEYORS
Emt E
200 & PLANNERS
52.42ha
12 Maple Street
PO Box 639
'VeP Cooroy Qld 45
Ph. (07) 54426121
Fax. (07) 54425125
Email. of ficegmwasurveys.com.ou
10.52ha
CliexE ROBERTS BROS
HOLDINGS.
PLAN SHOWING
HOUSE SITE AREAS AT
SF SITE RECONFIGURATION
OF LOT 200 ON
01
SP241367.
Emt H
60
SP103516 6 -2.031ha
OUSE )T8)
AREX 3.991ha PARISH: TUCHEK01
COUNTY: MARCH
Nc5 LOCAL GOVT: SUNSHINE COAST R.C.
LOCALITY: BLACK MOUNTAIN
Plan 1 of 1
Scale: 1:3000
Date: 23-11-11
Datum: AHD
orinin. PM 169230
190 RL 159.860
Ref:
102 ContInt: 2.0m
10-2954HS
SP177950
180
6.348ha P.U.L.
NOTE:
170
Cov D
1
SP199350
1
30 60 90 120 150m
Cov F RP891110
SP199350 )1)11111
Page 7
3
SP241367
21
SP241367
95°30'05"
443,573
61
6
SP241367
194°3740" 168°3850"
22.828
29.215
n 18'00'
BUILDING ENVELOPE -2.522
EFFLUENT DISPOSAL
— -30213157r.... AREA 2308612 120°5200"
3 • 47.16697857283'50" 25.366
SP241367 349°05'20"
14.860
6 5815"
BUILDING ENVELOPE
6 EFFLUENT DISPOSAL
AREA 410.2 300°5200"
24.139
222°35'
14.416
7
SP241367
303°0920"
19.724
2
17.67ha
Coy D
SP241367
1 oa 57
SP199350
Coy F
SP199350
mum
NOTE:
chew: ROBERTS Plan 1 of 1
BROS. PLAN SHOWING Date: 14-10-11
BUILDING ENVELOPE
MAX WATTERSON A7 EFFLUENT Scale: 1:2000
+ ASSOCIATES DISPOSAL AREAS AT Datum:
LOT 2 ON SP241367.
CONSULTING SURVEYORS Origin:
& PLANNERS PARISH: TUCHEK01
Cont.Int:
10 Maple Street
PO Box 639 COUNTY: MARCH
Cooroy Old 4563
LOCAL GOVT: SUNSHINE COAST R.C. 0 20 40 60 80 100m
Ph. (07) 54426121 Ref CADASTRAL SURVEYOR DATE:
Fax. (07) 54425125
Email. officalmwasurveys.com.ou
LOCALITY: BLACK MOUNTAIN I ,111,11111 10-2954H2
Page 8
MAX WATTERSON
ASSOCIATES
CONSULTING SURVEYORS
12 & PLANNERS
RP896928
12 Maple Street
PO Box 639
60 Cooroy Old 45
Ph. (07) 54426121
SP103516 Fax. (07) 54425125
1 Email. of lice gmwasurveys.comou
RP141330
98°51'20" 98°51,2 Client ROBERTS
40.347
330. 067 BROS.
44
co
Cov F • 98°51'20"
50.479
SP241367 tvicn
Emt E
BUILDING ENVELOPE
!U2
BUILDING ENVELOPE
SP241367 PLAN SHOWING
& EFFLUENT DISPOSAL
AREA 1.052ha
& EFFLUENT DISPOSAL (0
AREA 1893n1
BUILDING ENVELOPE
r
6/.829 dpg0
& EFFLUENT
84°2540
0 <0 188°51'40" DISPOSAL AREA AT
0'
.
0 srb 27.65
9 0
cP 232°5730" LOT 3 ON SP241367.
5.730
281°4915"
10.013
852 50'___ —
—95. 749 PARISH: TUCHEK01
COUNTY: MARCH
LOCAL GOVT: SUNSHINE COAST R.C.
3 LOCALITY: BLACK MOUNTAIN
10. 52ha
21 Scale: 1:1500
Plan 1 of 1
SP241367 Date: 14-10-11
Datum:
Origin:
Ref
Cont.Int:
10-2954H3
NOTE
443. 573
275°30'05'
2 CADASTRAL SURVEYOR DATE:
SP241367
0 15 30 45 60 75m
Page 9
Emt E
SP241367
RP141330 mwa
MAX WATTERSON
98°2045"
7.169 ASSOCIATES
96°5625"
13.516 113°0400"
12.314
CONSULTING SURVEYORS
7-r4
31.78311
, & PLANNERS
128°4T40"
12.314 200
12 Maple Street
84°3715"
7.169 SP241367
PO Box 639
Cooroy Old 45
Ph. ton 54426121
Fax. (on54425125
Email. of fice'n",mwasurveys.com.ou
cher,t ROBERTS
BROS.
21
SP241367 Project:
3.03ha PLAN SHOWING
BUILDING ENVELOPE
& EFFLUENT
DISPOSAL AREA AT
LOT 4 ON SP241367.
PARISH: TUCHEK01
BUILDING ENVELOPE &
EFFLUENT DISPOSAL AREA
4703rn2 2683220
7 671
COUNTY! MARCH
LOCAL GOVT: SUNSHINE COAST R.C.
31.293
268°3420"
228°3520"
LOCALITY: BLACK MOUNTAIN
DRIvE Scale: 1:1000
Plan 1 of 1
G?'.N.9035
'k - 5 9:N°
,,d 6'5
N,
Datum:
Date: 14-10-11
. / Origin:
— — _9,735,,
'42b 7.-- --- — --Z ,
zz
„.;)
21.252 _,,I,
'11. Emt G
SP241367 Cont.Int:
Ref.
267°3800"
235°24'
14.80330"
10-2954H4
3&'63 NOTE:
5
SP241367
6
SP241367 223°0820"
6.624 1 CADASTRAL SURVEYOR DATE:
Ci
<lsc,e2i Emt
0 10 20 30 40 50m
SP241367 II II Ij I t I
Pi9(20 f•—m-N.
\-4
Page 10
Emt G
SP214367
48°35'15"
9.361
3.0 88°32
01°21'25"
muva
MAX WATTERSON
4
SP241367 -,ASSOCIATES
CONSULTING SURVEYORS
PLANNERS
12 Maple Street
PO Box 639
Cooroy Qld 45
Ph. (071 54426121
Fox. (07) 54425125
Email. of fice:§mwasurveys.com.au
4°46'00"
Client ROBERTS
8.512 BROS.
BUILDING ENVELOPE 8
16°1550" EFFLUENT DISPOSAL
10.769 AREA 4699m"
Project:
61°1550"
Emt H 10.769 PLAN SHOWING
SP214367
BUILDING ENVELOPE
106° & EFFLUENT
0.
DISPOSAL AREA AT
LOT 5 ON SP241367.
6
SP241367
PARISH: TUCHEK01
COUNTY: MARCH
LOCAL GOVT: SUNSHINE COAST R.C.
LOCALITY: BLACK MOUNTAIN
Plan 1 of 1
Scale: 1:750
Date: 14-10-11
Datum:
22 Origin:
SP241367 Ref.
`1, Cont.Int:
79°3 10-2954H5
15.85
NOTE:
vo
7
SP241367 CADASTRAL SURVEYOR DATE:
0 7.5 15 22.5 30 37.5m
Page 11
21
SP241367
mvva
MAX WATTERSON
4 +ASSOCIATES
SP241367
CONSULTING SURVEYORS
& PLANNERS
12 Maple Street
PO Box 639
Cooroy Qld 45
Ph. (07) 54426121
Fax. (07) 54425125
Email. [email protected]
0
BUILDING ENVELOPE & 0 ch-t ROBERTS
EFFLUENT DISPOSAL AREA
BROS.
2060m.
04_\
0<)N-
4R,
Project:
106°15
0.48 PLAN SHOWING
BUILDING ENVELOPE
& EFFLUENT
DISPOSAL AREAS AT
LOT 6 ON SP241367 .
PARISH: TUCHEK01
COUNTY: MARCH
LOCAL GOVT: SUNSHINE COAST R.C.
BUILDING ENVELOPE &
EFFLUENT DISPOSAL AREA LOCALITY: BLACK MOUNTAIN
1387m.
51°5100" Plan 1 of 1
Scale: 1:1000
11.203
Date: 14-10-11
Datum:
Origin:
Ref
Contint
10-2954H6
NOTE:
2
SP241367
7 CADASTRAL SURVEYOR DATE.
SP241367
0 10 20 30 40 50m
1,1,1,1,1,1
Page 12
MAX WATTERSON
ASSOCIATES
CONSULTING SURVEYORS
P.
PLANNERS
12 Maple Street
PO Box 639
Cooroy GIG 45
Ph. (07) 54426121
Fax. (07) 54425125
Email. [email protected]
client: ROBERTS
BUILDING ENVELOPE
BROS.
& EFFLUENT DISPOSAL
AREA 9785m'
Project:
PLAN SHOWING
BUILDING ENVELOPE
& EFFLUENT
DISPOSAL AREA AT
LOT 7 ON SP241367.
PARISH: TUCHEK01
COUNTY: MARCH
LOCAL GOVT: SUNSHINE COAST R.C.
LOCALITY: BLACK MOUNTAIN
Plan 1 of 1
Scale: 1:1500
Date: 14-10-11
Datum:
Origin:
Ref.
Cont.Int:
10-2954H7
NOTE:
CADASTRAL SURVEYOR DATE:
0 15 30 45 60 75m
Ii II I Ii I
Page 13
12
SP896928
SP141330
mina
MAX WATTERSON
+ASSOCIATES
CONSULTING SURVEYORS
& PLANNERS
CO
980514 0 0 12 Maple Street
PO Box 639
Cooroy Old 45
Ph. (07) 54426121
74°5500" Fox. (07) 54425125
11.531
7 Emt E Email. officeX;(,Ynwasurveys.com.au
SP241367
ROBERTS
BROS.
BUILDING ENVELOPE
EFFLUENT DISPOSAL PLAN SHOWING
AREA 7323rn
BUILDING ENVELOPE
SP241367
& EFFLUENT
DISPOSAL AREA AT
LOT 21 ON SP241367.
PARISH: TUCHEK01
COUNTY: MARCH
LOCAL GOVT: SUNSHINE COAST R.C.
LOCALITY: BLACK MOUNTAIN
4
SP241367 Plan 1 of 1
Scale: 1(1000
Date: 14-10-11
Datum:
Origin:
Cent. let:
Ref
10-2954H21
NOTE:
262°32'00'
30'05' CADASTRAL SURVEYOR DATE:
2 6
SP241367 0 10 20 30 40 50m
SP241367
Page 14
200
SP241367
4
SP241367
Emt G
ACOCI
SP241367-->. DRIVE
95°54
30' 93°0050"
95° 4
z
104
/ /
SP241367
r‘l
5
SP241367
102
S P177950
BUILDING ENVELOPES
EFFLUENT DISPOSAL
AREA 7033nY
7
77
0
7
SP241367 <0
Sr
muva
CI:erL ROBERTS Plan 1 of 1 NOTE:
BROS. PLAN SHOWING Date: 14-10-11
BUILDING ENVELOPE
MAX WATTERSON & EFFLUENT Scale: 1:1000
ASSOCIATES DISPOSAL AREA AT Datum:
LOT 22 ON SP241367.
CONSULTING SURVEYORS Origin:
& PLANNERS PARISH: TUCHEK01
Cont.Int:
10 Maple Street
COUNTY: MARCH
PO Box 639
Cooroy ad 4563
LOCAL GOVT: SUNSHINE COAST R.C.
Ph. 07) 54426121
0 10 20 30 40 50m Ref. CADASTRAL SURVEYOR DATE:
Fax. (07) 54425125
Email. [email protected]
LOCALITY: BLACK MOUNTAIN 1,1,111,111 10-3954H22
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