File No A-
APPLICATION FOR MINOR VARIANCE
OR FOR PERMISSION
The undersigned hereby applies to the Committee of
Adjustment for the TOWNSHIP OF LAKE OF
THE WOODS under Section 45 of
the Planning Act, 1990 for relief,
as described in this application, from By-Law No. 60 (as amended).
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1. |
Name of Owner: |
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Telephone
Number: |
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2. |
Address: |
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3. |
Name of Agent
(if Any) |
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Telephone
Number: |
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Address: |
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NOTE: Unless otherwise requested, all
communications will be sent to the agent, if any. |
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4. |
Names and
addresses of any mortgagee, holders or charges or other encumbrances: |
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5. |
Street Address,
where applicable, and Legal description of subject land (registered plan
number and lot number or other legal description). |
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6. |
Nature and
extent of relief applied for: |
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7. |
Why is it not
possible to comply with the provisions of the by-law? |
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8. |
Dimensions and
land affected: |
Frontage: |
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Depth: |
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Area: |
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Width of
Street: |
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9. |
Particulars of
all buildings and structures on or proposed for the subject land (Specify
ground floor area, gross floor area, number of storeys, width, length,
height, etc.) |
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Existing: |
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Proposed: |
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Location of all
buildings and structures on or proposed for the subject land (Specify
distance from side, rear, and front lot lines); |
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Existing: |
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Proposed: |
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10. |
Date of
Acquisition of |
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11. |
Date of
construction of all buildings and structures on subject land. |
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12. |
Existing uses
of the subject property: |
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13. |
Existing uses
of abutting properties: |
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14. |
Length of time
the existing uses of the subject property have continued: |
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15. |
Municipal
services available (not applicable at this time): |
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16. |
Present
Official Plan provisions applying to the land: |
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17. |
Present Zoning
By-Law provisions applying to the land: |
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18. |
Has the Owner
previously applied for relief in respect of the subject property? |
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If the Answer
is yes, describe briefly: |
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19. |
Is the subject
property, the subject of a current application for consent under section 53
of the Planning Act, 1990. Yes No
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20. |
DECLARATION of Applicant or Authorized Agent I, ___________________ of the ______________________, in the District
of Rainy River solemnly declare that: All the statements
contained in this application are true and I make this solemn declaration
conscientiously believing it to be true and knowing that it is of the same
force and effect as if made under oath and by virtue of the Canada Evidence
Act. DECLARED before me at the ) ) , in the District
of Rainy ) ____________________ )
Signature of Applicant or River, this _____ day of ________, 2008 )
Authorized Agent _________________________ Signature of Commissioner etc. |
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AUTHORIZATION
OF OWNER
FOR
APPLICANT TO MAKE THIS APPLICATION
I, ___________________of the ________________of
_________________ in the
______________________of _____________________________
am the owner of the land that is the subject of this application and, as
evidenced by my signature below, I hereby authorize ____________________ to
make this application on my behalf.
___________________ _________________________________
Date Signature
of Owner
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If the applicant is not the
owner of the land that is the subject of this application, complete the
authorization of the owner concerning personal information set out below. |
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AUTHORIZATION OF OWNER REGARDING
PERSONAL INFORMATION |
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I, ___________________________________, am the owner
of the land that is the subject of this application and for the purpose of
the Freedom of Information and Protection of Privacy Act, I authorize
________________________________ as my agent for this application, to provide
any of my personal information that will be included in this application or
collected during the processing of the application. |
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Date |
Signature of Owner |
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Consent
of the Owner |
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Consent of the Owner to the Use
and Disclosure of Personal Information |
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I, _________________________________________, am the
owner of the land that is the subject of this application and for the
purposes of the Freedom of Information and Protection of Privacy Act, I authorize
and consent to the use by or the disclosure to any person or public body of
any personal information that is collected under the authority of the
Planning Act for the purposes of processing this application. |
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Date |
Signature of Owner |
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Notes:
1.
It is required that Eight (8) copies of this application be filed with the
secretary-treasurer of the Committee of Adjustment (Clerk-Treasurer), together
with the plan referred to in Note 2, accompanied by a fee of $150.00 In cash or by cheque made payable
to the Treasurer of the Township of Lake of the Woods.
2.
Each copy of this application must be accompanied by a plan showing the
dimensions of the subject land and of all abutting land and showing the
location, size and type of all buildings and structures on the subject and
abutting land. The Committee of
Adjustment (Council) may require that the plan be signed by an
3.
As the Applicant, you are
responsible for ensuring that this application includes a request for all of
the necessary variances in order to obtain compliance with the