Planning Act Form 5 - Change application form

      Unit No.                    Street No.                             Street Name and Type                     Suburb

b)    Postcode                    Lot No.                                Plan Type and Number (e.g.               Local Government
                                                                         RP, SP)                                  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 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        Datum                 Local Government Area(s)
                                                                              Ref.                              (if applicable)

                                                                                              WGS84
                                                                                  54
                                                                                              GDA94
                                                                                  55
                                                                                  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
 Noosa Shire Council



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
                                     51993.1086                         06/12/1993
     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):

 Construction of suspended tiled terrace, swimming pool and boundary fencing




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