Looking for a Australian Legal Forms And Templates? Download it for free!

9) Referral details - Do any aspects of the change application require referral for any referral requirements?

Note: The application must be referred to each referral agency triggered by the change application as if the change application was the original

development application including the proposed change.

Yes – the completed Sections 1 and 2 of Part 5 (Referral details) of DA Form 1 as it relates to the change application is

provided with this application. Where referral is required for matters relating to building work the referral checklist for

building work is also completed.

10) Information request under Part 3 of the DA Rules

I agree to receive an information request if determined necessary for this change application

I do not agree to accept an information request for this change application

Note: By not agreeing to accept an information request I, the applicant, acknowledge:



that this change application will be assessed and decided based on the information provided when making this change application

and the assessment manager and any referral agencies relevant to the change application are not obligated under the DA Rules to

accept any additional information provided by the applicant for the change application unless agreed to by the relevant parties



Part 3 of the DA Rules will still apply if the application is an application listed under section 11.3 of the DA Rules.

Further advice about information requests is contained in the DA Forms Guide.

11) Further details

Part 7 of DA Form 1 is completed as if the change application was a development application and is provided with this

application.

PART 6 – CHECKLIST AND APPLICANT DECLARATION

12) change application checklist

I have identified the:



responsible entity in 3); and



Yes

for a minor change, any affected entities; and



for an ‘other’ change all relevant referral requirement(s) in 9)

Note: See the Planning Regulation 2017 for referral requirements

For an ‘other’ change application, the relevant sections of DA Form 1 – Development

Yes

details have been completed and is attached to this application

Not applicable

For an ‘other’ change application, where building work is associated with the change

Yes

application, the relevant sections of Form 2 – Building work details have been

Not applicable

completed and is attached to this application

Supporting information addressing any applicable assessment benchmarks is attached

to this application

Note: This includes any templates provided under 23.6) of DA Form 1 that are relevant as a

Yes

result of the change application, a planning report and any technical reports required by the

relevant categorising instrument(s) (e.g. the local government planning scheme, State Planning

Policy, State Development Assessment Provisions). For further information, see DA Forms

Guide: Planning report template.

Relevant plans of the development are attached to this development application

Yes

Note: Relevant plans are required to be submitted for all relevant aspects of this change

application. For further information, see DA Forms Guide: Relevant plans.

24) Applicant declaration

By making this change application, I declare that all information in this change application is true and correct.

Where an email address is provided in Part 1 of this form, I consent to receive future electronic communications from

the responsible entity and any relevant affected entity or referral agency for the change application where written

information is required or permitted pursuant to sections 11 and 12 of the Electronic Transactions Act 2001.

Note: It is unlawful to intentionally provide false or misleading information.

Page 3

Planning Act Form 5 - Change application form

Version 1.0—3 July 2017

Change Application Form - Department Of Infrastructure, Local Government And Planning Page 3

Related Articles

Related forms

Related Categories