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Pre_Request_Response_Application

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                                                                                                   Pre-Request Response Application



                                                                                                                                   Planning Act 2016
ALL questions MUST be completed unless the form indicates otherwise.
This form must be submitted to Council accompanied by the applicable fee.
Attach extra pages if there is insufficient space on the form.
All terms used on the form have the meaning given in the Planning Act 2016 or the Planning Regulation 2017.

1. Details of person making the request
                                Barefoot Bar and Grill
Full name – individual or company
Contact Name – for company C/- Adapt Town Planning (Tiani Boulton)
Postal address PO Box 7618
Suburb Sippy Downs                                                                    State QLD                          Postcode 4556
Business phone                                      A/H phone                                           Mobile 0404 924 160
Email address [email protected]                                                        Fax

2. Details of existing approval
Type of approval (please tick ALL applicable categories)                      Which entity issued approval?
x
    Development Permit                                                           Council
    Preliminary Approval                                                     x
                                                                                  Planning & Environment Court
x
    Material Change of Use                                                       Minister (under part 11, division 2)
    Reconfiguring a Lot                                                          Other entity – please specify
    Operational Works
    Building Works
    Plumbing or Drainage Works
    Environmentally Relevant Activity
Application number/council reference D:3226 of 2000 (Council Ref: 18492 DA)                                          Date issued 09/11/2000
Is the approval for a mobile and temporary ERA?                                               x
                                                                                                  No                     Yes – complete below
Insert the name of each local government area in which the mobile and temporary ERA is proposed to operate/operating



3. Nature of proposed change/s (please tick ALL applicable categories)
To change the development approval issued by:                                 To change the conditions issued by;
x
    Planning & Environment Court                                             x
                                                                                  Planning & Environment Court
    Minister                                                                     Council (as a Concurrence agency)
    Other entity – please specify:                                               Minister
                                                                                  Concurrence Agency – please specify:
                                                                                  Other entity – please specify:
Please attach documentation outlining the detail of and the reasons and justification for the requested change/s.




Privacy
Council will use any personal information provided for the intended purpose only and for remaining in contact with you. Council is authorised to collect
this information in accordance with the Local Government Act 2009 and other Local Government Acts. Your personal information is only accessed by
persons authorised to do so. Your personal information is dealt with in accordance with council’s privacy policy.


www.noosa.qld.gov.au                        [email protected]                       T 07 5329 6500
PO Box 141 Tewantin Qld 4565                                                            ABN 97 969 214 121

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4. Location of the premises
Unit No.                   Street No 269             Street Gympie Terrace
Suburb Noosaville                                                  State QLD                  Postcode 4566
Lot no.                    Plan type & plan no.
0                          SP129587




5. Declaration of applicant
I/We, the applicant, declare that the above information is correct in all respects, at the time of lodgement of this
application with Council. Should any of the details given in relation to this application be changed in the future, the
applicant shall advise Council in writing prior to any such change being implemented.
Signature                                                                               Date 15/12/20


OFFICE USE ONLY
Application no.     Amount paid       Date paid         Receipt no.        Initial           Date stamp


Receiving Officer




Payment options

In Person    9 Pelican Street, Tewantin: 8.30 am to 4.30 pm Monday to Friday (excludes public holidays).
By Link      A payment link will be forward to you once your application has been lodged.
By mail      Cheque or money order to be made payable to Noosa Council.
              Cheque                                          Money order

                                                                                                              Page 2 of 2

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