File No
APPLICATION FOR ZONING BY-LAW AMENDMENT
INFORMATION AND
MATERIAL TO BE PROVIDED BY APPLICATION UNDER SUBSECTION 34(10.1) OF THE
PLANNING ACT (
1. The name, address and telephone number of
the Applicant:
2. If known the names and full addresses of
the holders of any mortgages, charges or other encumbrances in respect of the
subject land:
3. The current Official Plan designation of
subject land: _____________________
4. The current zoning of the subject land: _____________________________
5. The nature and extent of the rezoning
requested:
6. The reason why the rezoning is requested
7. The description of the subject land, such
as the municipality, concession and lot numbers, registered plan and lot
numbers, reference plan and part numbers and name of street and number:
8. The frontage, depth and area of the
subject land:
Frontage: Depth:
9. Whether access to the subject land is by a
provincial highway, a municipal road that is maintained all year or seasonally,
another public road or a right of way or by water:
10. If access to the subject land is by water
only, the parking and docking facilities used or to be used and the approximate
distance of these facilities from the subject land and the nearest public land:
11. The existing uses of the subject land:
12. Are there any buildings or structures on
the subject land: Yes No
13. If yes, provide, for each building or
structure, the type of building or structure, the setback from the front lot
lines, rear lot line and side lot lines, the height in metres of the building
or structure and the dimensions or floor area of the building or structure:
14. The proposed uses of the subject land:
15. Are any buildings or structures proposed for
the subject land?
16. If yes, for each building or structure,
the type of building or structure proposed, the setback from the front lot
line, rear lot line and side lot lines, the height in metres of the building or
structure and the dimensions or floor area of the building or structure:
17. If known, the date the subject land was
acquired by the current owner:
18. If known, the date the existing buildings
or structures on the subject land were constructed:
19. If known, the length of time that the existing
uses of the subject land have continued:
20. Whether water is provided to the subject
land by a publicly owned and operated piped water system, a privately owned and
operated individual or communal well, a lake or other water body or by other
means:
21. Whether sewage disposal is provided to the
subject land by a publicly owned and operated piped water system, a privately
owned and operated individual or communal septic system, a privy or other
means:
22. Whether storm drainage is provided by
sewers, ditches, swales or other means:
23. If known, is the subject land the subject
of an application under the Act for approval of a plan of subdivision or a
consent:
Yes
No
24. If the answer to item #23 is yes, and if
known, the file number of the application and status of the application:
25. If known, has the subject land ever been
the subject of an application under Section 34 of the Act:
Yes
No
26. A
sketch showing the following:
a. the boundaries and dimensions of the
subject land.
b. The location, size and type of all
existing and proposed buildings and structures on the subject land, indicating
the distance of the buildings or structures from the lot lines.
c. The approximate location of all natural
and artificial features on the subject land and on land that is adjacent to the
subject land that, in the opinion of the applicant, may affect the
application. Examples include buildings,
railways, roads, watercourses, drainage ditches, river or stream banks,
wetlands, wooded areas, wells and septic tanks.
d. The current uses on land that is adjacent
to the subject land.
e. The location, width and name of any roads
within or abutting the subject land, indicating whether it is an unopened road
allowance, a public traveled road, a private road or a right-of-way.
f.
If
access to the subject land is by water only, the location of the parking and
docking facilities to be used.
g. The location and nature of any easement
affecting the subject land.
27. An
affidavit or sworn declaration by the applicant that the information required
under this Schedule and provided by the applicant is true.
28. Authorization of Owner for Applicant to
make application, if owner is not the applicant.
NOTES:
It is required that
Eight (8) copies of this
application be filed with the Clerk-Treasurer together with the plan referred
to in #26, accompanied by a fee of $250.00
In cash or by cheque made payable to the Township of Lake of the Woods.
DECLARATION
Of
Applicant or Authorized Agent
I, ________________________ of the
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 Ac.
DECLARED before me at the )
)
)
District of Rainy River, this _______ ) Signature of Applicant or
) Authorized Agent
day of _______________20___ )
_________________________
Signature of Commissioner etc.
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 for re-zoning 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 for a consent 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 consent 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 |
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Signature
of Owner |
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