Planning Act Form 5

           4565           4                 RP77225                                                 Noosa Shire Council
           Unit No.       Street No.        Street Name and Type                                    Suburb
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 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               RAL21/0009                         17/01/2021 (NDN)                    Noosa Shire 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):

 Change to 2 into 2 lot realignment with access easement

 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