Change to DA (Amend/Remove condition 3 - 195 to 210 EGM's) - MCU16/0079.04

     Change application form
     Planning Act Form 5 (version 1.1 effective 22 JUNE 2018) made under Section 282 of the Planning Act 2016.
     This form is to be used for a change 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
1) Applicant details
Applicant name(s) (individual or company full name)                   TEWANTIN NOOSA RSL & CITIZENS MEMORIAL CLUB INC
Contact name (only applicable for companies)                          PHI LLIP JOHN STEPHENSON
Postal address (P.O. Box or street address)                           5 MEMORIAL AVENUE
Suburb                                                                TEWANTIN
State                                                                 QLD
Postcode                                                              4565
Country                                                               AUSTRALIA
Email address (non-mandatory)                                         ceonoosarsl.com.au
Mobile number (non-mandatory)                                         0418 194358
Applicant's reference number(s) (if applicable)                       MCU16/0079.02

2) Owner's consent - Is written consent of the owner required for this change application?
Note: section 79(1A) of the Planning Act 2016 states the requirements in relation to owner's consent.
fl Yes — the written consent of the owner(s) is attached to this change application
xp No



     PART 2 - LOCATION DETAILS

3) Location of the premises (complete 3.1) or 3.2), and 3.3) as applicable)
3.1) Street address and lot on plan
xLj Street address AND lot on plan (all lots must be listed), or
   Street address AND lot on plan for an adjoining or adjacent property of the premises (appropriate for development in
water but adjoining or ad'acent to land e.g. jetty, pontoon; all lots must be listed).
          Unit No.          Street No.           Street Name and Type                            Suburb
                            5                    MEMORIAL AVENUE                                 TEWANTIN
a)
          Postcode          Lot No.              Plan Type and Number (e.g. RP, SP)              Local Government Area(s)
          4565              10                   SP 273411                                       NOOSA SHIRE
          Unit No.          Street No.           Street Name and Type                            Suburb
b)
          Postcode          Lot No.              Plan Type and Number (e.g. RP, SP)              Local Government 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                                                   .
    Coordinates of premises by longitude and latitude
Longitude(s)              Latitude(s)               Datum                                      Local Government Area(s) (if applicable)
N/A                                                 U WGS84
                                                    LI GDA94
                                                    LI Other:
LII Coordinates of premises by easting and northing


                                                                                                                      Queensland
                                                                                                                      Government