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26092018154523 · 51901.3589.04

Attached to the e-mail Change to DA - Partial Enclosure of Balcony Unit 5 - 51901.3589.04.

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Department of Infrastructure, Local Government and Planning

Change application form
Planning Act Form 5 (version 1.0 effective 3 July 2017) made under Section 282 of the Planning Act 2016.

This form is to be used for a change an application made under section 78 of the Planning Act 2016. It is important when
making a change application to be aware of whether the application is for a minor change that will be assessed under
section 81 of the Planning Act 2016 or for an ‘other’ change that will be assessed under section 82 of the Planning Act
2016.

An applicant must complete all parts of this form, and provide any supporting information that the form identifies as being
required to accompany the change application, unless stated otherwise. Additional pages may be attached if there is
insufficient space on the form to complete any part.

Note: All terms used in this form have the meaning given under the Planning Act 2016, the Planning Regulation 2017, or the Development
Assessment Rules (DA Rules).

PART 1 — APPLICANT DETAILS

Applicant name(s) (individual or company full name) LISANG, pesiagnt
Contact name (only applicable for companies) LISA smite

Postal address (P.O. Box or street address) PO BOX Yosl
Suburb Noosa HEADS

State Ss

Postcode US lo

Country AUSTEALLA

Email address (non-mandatory) LIS ANicy DESISINO ME. com
Mobile number (non-mandatory) OuBF S14 SSS

Applicant's reference number(s) (if applicable)

 

 
     

2) Owner's consent - Is ‘written consent of the owner required for this. change application?
Note: section 79(1)(b){iii) of the Planning Act 2016 states the requirements in relation to owner’s consent.

[Yes ~ the written consent of the owner(s) is attached to this change application
L] No — proceed to 3) in Part 2

    
   
 

 

PART 2 — RESPONSIBLE ENTITY DETAILS

3) Identify the responsible entity that will be assessing this change application
Note: see section 78(3) of the Planning Act 2016

 

 

PART 3 — CHANGE DETAILS

4) Provide details of the existing development approval subject to this change application

 

 

Approval type Reference number Date issued Assessment
manager/approval entity
(7J Development permit SIQO! .8S€C] 03 sali hus, Piencavr

ALBCE .«

(J Preliminary approval

(J Development permit
(2 Preliminary approval

 

 

 

 

 

 

 

      

Queensland
Government

1S
Coed

   
Full text of the other 12 pages

Page 2

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):

 

 

 

PARTIAL ENCLOSURE CF BALCONY

 

5.2) What type of change does this application propose?

(Minor change application — proceed to Part 4
CJ Other change application — proceed to Part 5

 

 

 

 

PART 4— MINOR CHANGE APPLICATION REQUIREMENTS

6) Are there any affected ‘entities for this change application

LA No — proceed to Part 6
CO 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)

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

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

(No
(2 Yes — pre-request response is attached to
this change application

 

 

 

 

 

 

 

 

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.gid.qov.au.

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

  

development approval?.

[No

(J 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?
(No — proceed to 9)

[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
[7] Yes - the completed Part 5 (Building work details) of DA Form 2 as it relates to the change application is provided with

this application. Dior udic BOO.

 

 

 

 

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

Page 3

Department of Infrastructure, Local Government and Planning

9) Referral details. - Do any aspects of the change application require referral for any referral requirements?.

Note: The application must be referred to‘each referral agency triggered by the change application as ifthe change application was the original
development application including the proposed change.

k-TNo

CJ Yes ~ the completed Sections 1 and 2 of Part 5 (Referral details) of DA Form 1 as it relates to the change application is
provided with this application. Where referral is required for matters relating to building work the referral checklist for
building work is also completed.

 

 

10) Information request under.Part'3 of the DA Rules

[4 agree to receive an information request if determined necessary for this change application
[J | do not agree to accept an information request for this change application
Note: By not agreeing to accept an information request |, the applicant, acknowledge:

* that this change application will be assessed and decided based on the information provided when making this change application
and the assessment manager and any referral agencies relevant to the change application are not obligated under the DA Rules to
accept any additional information provided by the applicant for the change application unless agreed to by the relevant parties

¢ Part 3 of the DA Rules will still apply if the application is an application listed under section 11.3 of the DA Rules.

Further advice about information requests is contained in the DA Forms Guide,

MDM EU clme (1c

(J Part 7 of DA Form 1 is completed as if the change application was a development application and is provided with this
application.

 

 

 

 

PART 6 — CHECKLIST AND APPLICANT DECLARATION

| have identified the:
¢ responsible entity in 3); and
e fora minor change, any affected entities; and Yes
e for an ‘other’ change all relevant referral requirement(s) in 9)

Note: See the Planning Regulation 2017 for referral requirements

For an ‘other’ change application, the relevant sections of DA Form 1 -— Development C7 Yes
details have been completed and is attached to this application CD Not applicable

 

 

For an ‘other’ change application, where building work is associated with the change be ECD
application, the relevant sections of Form 2 ~ Building work details have been Nes ligabl
completed and is attached to this application Not applicable

Supporting information addressing any applicable assessment benchmarks is attached

to this application

Note: This includes any templates provided under 23.6) of DA Form 1 that are relevant as a

result of the change application, a planning report and any technical reports required by the L] Yes
relevant categorising instrument(s) (e.g. the local government planning scheme, State Planning

Policy, State Development Assessment Provisions). For further information, see DA Forms

Guide: Planning report template.

Relevant plans of the development are attached to this development application

Note: Relevant plans are required to be submitted for all relevant aspects of this change [Yes
application. For further information, see DA Forms Guide: Relevant plans.

 

 

 

 

24) Applicant declaration

[*} By making this change application, | declare that all information in this change application is true and correct.
[Where an email address is provided in Part 1 of this form, | consent to receive future electronic communications from
the responsible entity and any relevant affected entity or referral agency for the change application where written
information is required or permitted pursuant to sections 11 and 12 of the Electronic Transactions Act 2001.

Note: It is unlawful to intentionally provide false or misleading information.

 

 

 

Page 3
Planning Act Form 5 - Change application form
Version 1,0—3 July 2017

Page 4

Department of Infrastructure, Local Government and Planning

 

 

Privacy — Personal information collected in this form will be used by the responsible entity and/or chosen assessment
manager, any relevant affected entity or referral agency and/or building certifier (including any professional advisers which
may be engaged by those entities) while processing, assessing and deciding the change application.

All information relating to this change application may be available for inspection and purchase, and/or published on the

assessment manager's and/or referral agency’s website.

Personal information will not be disclosed for a purpose unrelated to the Planning Act 2016, Planning Regulation 2017 and

the DA Rules except where:

« such disclosure is in accordance with the provisions about public access to documents contained in the Planning Act
2016 and the Planning Regulation 2017, and the access rules made under the Planning Act 2076 and Planning
Regulation 2017; or

¢ required by other legislation (including the Right to Information Act 2009); or

e otherwise required by law.

This information may be stored in relevant databases. The information collected will be retained as required by the Public

Records Act 2002.

 

 

 

PART 7 ~ FOR OFFICE USE ONLY

Date received: [t~—OY Reference number(s): |

Note; For completion by assessment. manager if applicable
Description of the work
QLeave project number
Amount paid ($)
Date paid
Date receipted form sighted by assessment manager
Name of officer who sighted the form

 

 

 

 

 

 

 

 

 

 

 

 

The Planning Act 2016, the Planning Regulation 2077 and the DA Rules are administered by the Department of
Infrastructure, Local Government and Planning. This form and all other required change application materials should be
sent to the responsible entity.

Page 4
Planning Act Form 5 - Change application form
Version 1.0-——-3 July 2017

Page 5

 

RIVER GUMS CTS 10491
1 RUSSELL STREET NOOSAVILLE

As Committee Chairperson for Rivergums CTS 10491, 1 Russell
Street, Noosaville, I confirm that, via email distribution of
documentation, the committee was made aware that the owners of
Unit 5 are proposing to install a lift and new sliding aluminium and
glass shutters and doors to the balcony area, similar to the finish in the
rest of the unit block.

I have received email confirmation from all members on 25"
September 2018, that this development plan has been sighted and
confirmed that the committee had no objection to the Permissible Use
application being lodged with Noosa Council.

 

Alan Cadd
Rivergums CTS 10491
Chairman

Dated: 25/'9/ 2o1 ¥

Page 6

 

 

     

OWNERS CONSENT =
Privacy Act 1988, Information Privacy Act 2009 and Sustainable Planning Act 2009. en TO

  

 

 

PACIFIC BCQ_

BUILDING CERTIFICATION QUEENSLAND.
Dear Sir/Madam:

Pursuant to the Privacy Act 1988, the Information Privacy Act 2009, the Sustainable Planning Act 2009 and the Local
Government Act 2009, I/We being the Registered Owners of the property located at:

Address:

5/ 1-3 RUSSELL STREET NOOSAVILLE 4566
Described as:

Lot BUP 4699

Local Government Area:

NOOSA COUNCIL
Consent to Pacific BCQ:
(1) Acting on my/our behalf in making all requisite Development Applications, Preliminary Applications, Concurrence

Agency Applications, Plumbing Applications and/or Local Law Applications in relation to abovementioned
property and premises ;

(2) Obtaining all requisite property information and/or records inclusive of details and copies of Approvals, Decision
Notices, Permits, Plans, Specifications, Requisitions and/or Enforcement Action details in relation to the
abovementioned property and premises;

(3) Entering the property at all reasonable times during business hours for the purposes of inspections; and

(4) Representing our interests in matters of Appeal to the Building and Development Dispute Resolution Committees
where required.

Yours faithfully

 

 

Name! Designation* Signature Date
(Please print) (Director, Secretary etc. ~
if applicable)
LA-UREWLE JEAJSINE CS QO Fe
YAS Gan A

 

 

 

 

 

 

 

 

 

T If there are multiple individual owners of the land the signature of each owner is required.

+ A company owns the land consent without the use of a common seal by the signatures of (a) 2 directors of the company;
or (b) a director and a company secretary of the company; or (c) for a proprietary company that has a sole director who is
also the sole company secretary—that director.

ng Approvals | BCA Consultancy Services { Regulatory

 

ercial Buildi De
. Commercia  ceanaminininrseanisisinenitt ttt tant evelopme,
Domestic and rennin ett Co-ordination
a abn, 28 166 025 429 ne On
ae . ke,
ee ® 5412 1520 1 © 5412 1522 | © info@'pacificbeq.com.au [email protected] ne

Unit 2/11 Project Avenue, Noosaville, Qld 4566 | PO Box 1901, Noosaville BC, Qld 4566

 

Page 7

 

 

 

 

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150 L
® 9625 6215 |
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600 1200 , 900 1500 300 1610 300900 600
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4
4
eee L JEAVONS UNIT 5 D.A.
Project number #1
RIVERGUMS UNIT 5 Date ara A103
RUSSELL ST NOOSAVILLE Drawn by
Checked by LS | Scale 41: 100

 

 

 

 

 

 

 

 

 

 

21/NRIPNAR 1N-AQ-AR AM

Page 8

 

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5 TOP PLATE i
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Page 10

 

o

2)

North
4: 100

 

East
1: 100

 

 

 

 

 

   

SS Level 4 a
14786

Level 3 =
12386

Level 2 a
9557

Level 1 .
6900

Level 4 a
14786
Level 3 a
12386
Level 2 a
9557

Level 1 A.
6900

 

 

 

 

 

 

 

Description

 

 

BODY CORP

RIVERGUMS UNITS
RUSSELL ST NOOSAVILLE
QLD 4566 LOT4 BUP 4699

 

ELEVATIONS

 

Project number

#1

 

Date

71912018

 

Drawn by

A101

 

 

Checked by

ts

 

Scale 4:100

 

 

 

 

TINAIINIR WAR-2AQ DM

Page 11

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Page 12

Page 13

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