24-1024 MCA - DA Form 5 · 132004.4321.01

 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
 Foundation Building Approvals



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
    Development permit                                                                                     Noosa Shire Council
                                     132004.4321                       28/06/2004
    Preliminary approval
    Development permit
    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) :
 Minor change to original approval 132004.4321 to allow for an increase in site cover due to proposed patio roof.

 6.2) What type of change does this application propose?
    Minor change application – proceed to Part 5
    Other change application – proceed to Part 6
PART 5 – MINOR CHANGE APPLICATION REQUIREMENTS

 7) Are there any affected entities for this change application
    No – proceed to Part 7
    Yes – list all affected entities below and proceed to Part 7


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