DA Form 5

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
 Noosa 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                RAL21/0014 &                       14/03/2022                          Noosa Council
 ☐ Preliminary approval              DBW21/0127
 ☐ 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):
 Refer to cover letter.

 6.2) What type of change does this application propose?
 ☒ Minor change application – proceed to Part 5
 ☐ Other change application – proceed to Part 6




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