Change application

3.2) Coardinates of premise

 

| (Coordinates of premises by longitude and latitude
| Longitude(s) | Latitude(s) | Datum Local Government Area(s) (if applicable)

| Gwese4
| LJ GDAg4
| C Other: { _
(C1 Coordinates of premises by easting and northing
| Easting(s) Northing(s) | Zone Ref. | Datum _
a 054 ~T Alwesea
(1) Gpa94
other: [~

 

 

 

 

 

 

Local Government Area(s) (if applicable)

 
  
 
      
   

 

 

3.3) Additional premises

   

LJ Additional premises are relevant to the original development approvai and the detaiis of these premises have
erhot attached in a schedule to this application
N

|
[ lot required aa

 

 

PART 3— RESPONSIBLE ENTITY DETAILS

    

  

nsible entity that will be assessing this change application

 

W the Planning Act 201

   
    

 

   
   

Assessment
manager/approval entity

Development permit it Clean a
oO Preliminary approval JS 2006-2! i " Coa fri

LD Development permit
(1 Preliminary approval

Approval type

 

 

 

 

 

 

 

 

 

6) Type of change proposed

6:1) Provide a brief description of the chang aistolem Com iateae| bsTalme 9) 0]¢8) es

   

Oi Minor change application — proceed to Part 5
C Other change application — proceed to Part 6

 

Page 2
Planning Act Form 5 - Change application form
Version 1.2 — 7 February 2020