Form 5 · 51987.2900.1

Department of Infrastructure, Local Government and Planning

 

5) Type of change proposed

5.1) Provide a brief description of the changes proposed to the development approval (e.g. changing a development approval for a
5 unit apartment building to provide for a 6 unit apartment building):

 

yp, IFEK
Minor CHALE TO DEVEL EPMEWT A PPRovVAK (7 Pe tell.) Fok
ADDITIONS TO Acc Orvis DAT OP eb wot

 

5.2) What type of change does this application propose?
Minor change application — proceed to Part 4
(J Other change application — proceed to Part 5

 

PART 4 — MINOR CHANGE APPLICATION REQUIREMENTS

6) Are there any affected entities for this change application
[4 No — proceed to Part 6

C1 Yes - list all affected entities below and proceed to Part 6
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 pre-
request response notice for the application has | request response provided)

been given, a copy of the notice must
accompany this change application)

LI No

CJ Yes — pre-request response is attached to
this change application

LC No
CJ Yes — pre-request response is attached to
this change application

LI No
C1 Yes — pre-request response is attached to
this change application

 

 

 

 

 

 

 

 

L

 

 

PART 5 — 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 www.dilgp.gld.gov.au.

7) Location details - Are there any additional premises included in this change application that were not part of the original

development approval?

LI No
LJ Yes — complete Part 2 (Location details) of DA Form 1 as it relates to the additional premises is completed and
provided with this application.

 

      
 

8) Development details
8.1) Are there any new or changed development aspects included in this change application that are not part of the
original development approval?

L] No — proceed to 9)
LJ Yes — the completed Sections 1 and 2 of Part 3 (Development details) of DA Form 1 as these sections relate to the
new or changed aspects of development are provided with this application.

     
 
   
 

8.2) Does the change application involve building work?

LJ No
LJ Yes — the completed Part 5 (Building work details) of DA Form 2 as it relates to the change application is provided with
this application.

  

 

Page 2
Planning Act Form 5 - Change application form
Version 1.0—3 July 2017