DA Form 5 · 51992.532.01

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

 ☐    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
Longitude(s)            Latitude(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 this development application and their details 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
                                        TPC2470                                                                Noosa Council
 ☐    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):




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