Fillable DEVELOPMENT APPLICATION FORM PRE- CONSULTATION APPLICATION FORM By-Law (Dufferin County)

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DEVELOPMENT APPLICATION FORM PRE- CONSULTATION APPLICATION FORM By-Law (Dufferin County)

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DEVELOPMENT APPLICATION FORM PRE-
CONSULTATION APPLICATION FORM By-Law
2019-04 – Schedule A
For Office Use Only
File Number:
Roll Number(s):
Application Fee:
Application
Received: DD/MM/YYYY
Application
Deemed Complete:
DD/MM/YYYY
Section One: General Information
Pre-consultation Procedure
The County of Dufferin requires applicants to meet with the County’s planning staff prior to
submitting an application under the Planning Act. Pre-consultation meetings are hosted by
the County and are required to be attended by the applicant or their representative(s). The
pre-consultation meeting allows the applicant and/or their representative(s) to present and
discuss the development proposal with relevant staff, and also allows staff to clarify the
application process, provide preliminary comments on the proposal, identify any key issues
and the approvals that will be required, as well as determine which technical studies and
supporting information/materials must be submitted with the planning application in order
to be considered a complete application under the Planning Act.
Timing and Required Information
Complete and return the pre-consultation request and the supporting material to:
County of Dufferin – Attention Jenny Li, Planning Co-ordinator
55 Zina Street, Orangeville, Ontario L9W 1E5
Upon receipt of a completed Pre-Consultation Application form and all
required/supplementary information, the County will schedule a pre-consultation meeting
involving the applicant, local municipal and County planning staff, and other relevant
agencies where necessary. Subsequent to a pre-consultation meeting, the County will
provide the applicant and/or owner with a signed Record of Pre-consultation. The Record
will contain a list of information and materials that will be required to process the subject
application(s) and meet the requirements of a complete application under the Planning
Act.
COUNTY OF DUFFERIN
PRE-CONSULTATION APPLICATION FORM By-Law
2019-04 – Schedule A
2
Section Two: Application Information
1. Property Owner’s Information
Owner’s Name:
Mailing Address:
Email Address:
Postal Code:
Home Phone:
Work Phone:
2. Agent/Applicant Information
(name of person to be contact about the application, if different from the owner)
Name of Contact:
Mailing Address:
Email Address:
Postal Code:
Home Phone:
Work Phone:
3. Authorization Form
The Owner(s) formal authorization permitting the applicant to make this application on the Owner(s)
behalf to the County of Dufferin.
, the owner(s) of the property
I/We
subject of this application, hereby authorize
to make this application on my/our behalf to the County of Dufferin.
Witness:
Date:
Owner’s Signature:
Date:
Section Three: Subject Property
1. Location of the Subject Land
Street Name and Number:
Registered Plan Number:
Reference Plan Number:
Part/Block/Lot:
Parcel/Pin No.:
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COUNTY OF DUFFERIN
PRE-CONSULTATION APPLICATION FORM By-Law
2019-04 – Schedule A
3
Concession & Lot Number:
Street Name and Number:
Lot Area (sq. m. or ha): Lot Frontage (m):
Section Four: Property Information
1. Describe the Current Land Use(s) on the Property:
2. Current Official Plan Designation
Current Official Plan Designation: County OP:
Local OP:
Does the proposed use comply with the existing Official Plan designation(s)?
Yes:
☐
No:
☐
If No, explain the amendment(s) required:
3. Easements and Encumbrances
Are there any encumbrances on the property?
Yes:
☐
No:
☐
COUNTY OF DUFFERIN
PRE-CONSULTATION APPLICATION FORM By-Law
2019-04 – Schedule A
4
If Yes, please list:
Section Five: Property Description
1. Existing Property Description
Describe the current buildings or structures on the property and the natural features and
vegetation on the property and adjoining property: (Should further space be required for
responses, or to provide additional information to assist staff in considering the proposal, please
provide by attachment).
2. Proposed Development Description
Provide a detailed description of the proposed development: (Should further space be required
for responses, or to provide additional information to assist staff in considering the proposal,
please provide by attachment).
COUNTY OF DUFFERIN
PRE-CONSULTATION APPLICATION FORM By-Law
2019-04 – Schedule A
5
Section Six: Authorization
1. Affidavit or Sworn Declaration
I, of the municipality of
make an oath and say (or solemnly declare) that the information contained in this application is
true and that the information contained in the documents that accompany this application is true.
Sworn (or declared) before me at the
in the
this day of
2. Permission to Enter Property
I/We, Hereby authorize the members of the
Committee of Adjustment, members of the staff of the County of Dufferin and designated
consultants to enter onto the above noted property for the limited purposes of evaluating the
merits of this application over the time this application is under consideration by the County
of Dufferin.
Date: Owner’s Signature:
3. Information Authorization of the Owner
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.
am the owner of the land that is subject to this application
for approval of a Planning Act application and for the purposes 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.
Date: Owner’s Signature:
The personal information collected on this form is collected under the authority of the Planning
Act and will be used during the Pre-Consultation process. Questions about the collection should
be directed to the Planning Coordinator at 519.941.2816 x 2509.
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DEVELOPMENT APPLICATION FORM PRE- CONSULTATION APPLICATION FORM By-Law (Dufferin County)

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Completed 8 April 2021

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