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Change Application Form - 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

1) Applicant details

Applicant name(s)

(individual or company full name)

Contact name

(only applicable for companies)

Postal address

(P.O. Box or street address)

Suburb

State

Postcode

Country

Email address

(non-mandatory)

Mobile number

(non-mandatory)

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

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

Development permit

Preliminary approval

Development permit

Preliminary approval

Change Application Form - Department Of Infrastructure, Local Government And Planning

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