1. SPA request-change-existing-approval-form · MCU16/0084

2. What are the details of the existing approval sought to be changed?


Type of approval           Identification number Date decision notice      Name of entity that issued the approval
                                                 or negotiated             or imposed the condition sought to be
                                                 decision notice           changed
                                                 issued

 x     Development         MCU16/0084            12 January 2017           Noosa Shire Council
       permit
       Preliminary
       approval


3. Is the approval for a mobile and temporary environmentally relevant activity (ERA)?


 x      No
        Yes—complete table A and then go to question 5

Table A—name of each local government area in which the mobile and temporary ERA is proposed to operate/ is operating




4. Location of the premises (complete table B and/or table C as applicable. Identify each lot in a separate row)


Table B—street address/lot for the premises or street address/lot on plan for the land adjoining or adjacent
to the premises
        street address/lot on the plan
        street address/lot on plan for the land adjoining or adjacent to the premises (appropriate for development
        in water e.g. jetty, pontoon)

Street address                                            Lot on plan description        Local government
                                                                                         area (e.g. Logan,
Unit      Street     Street name and official   Post-     Lot no.       Plan type        Cairns)
no.       no.        suburb/ locality name      code                    and plan no.

           140-142     Eumundi Noosa Road
                                                4565       2             RP173876          Noosa Shire Council
                       Noosaville, QLD




Request to change existing approval template                                                                      -2-