m{ã Note: Only applicable if lands are located within a floodplain area or adjacent to conservation land CVC comment is required.

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Kerry Nicholson
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Ilttft.k m{ã ('lntút Ie THE CORPORATION OF THE TOWN OF ORANGEVILLE COMMITTEE OF ADJUSTMENT FEE SCHEDULE AND INFORMATION SHEET MINOR VARIANCE APPLICATION 1.

to the Treasurer, Town of Orangeville. o Application Fee $800.00 a Request for Deferral (applicant initiated) $ 30.00 a Credit Valley Conservation (CVC) Requirements $280.

1 Ilttft.k m{ã ('lntút Ie THE CORPORATION OF THE TOWN OF ORANGEVILLE COMMITTEE OF ADJUSTMENT FEE SCHEDULE AND INFORMATION SHEET MINOR VARIANCE APPLICATION 1. The application shall be submitted to Susan Lankheit, Secretary-Treasurer, Committee of Adjustment, ST Broadway, Orangeville, Ontario, L9W 1K1 alongwith the applicable (cash or cheque) made payable to the Treasurer, Town of Orangeville. o Application Fee $ a Request for Deferral (applicant initiated) $ a Credit Valley Conservation (CVC) Requirements $ (Cheque to be made payable to Credit Valley Conservation) Note: Only applicable if lands are located within a floodplain area or adjacent to conservation land CVC comment is required. 2. lf the application is completed by an agent or solicitor, acting on behalf of the applicant, the Authorization Form attached to the application must be completed by the owner(s). lf the applicant is a Limited Company, the signing officer must affix the Gompany seal over his/her signature. 3. All questions on the application must be completed in full by the applicant or agent, and shall clearly explaín the intent of the proposal. An incomplete application may be returned to the applicant or agent. A// necessary variances musf be confirmed with the Planning Department prior to the application being considered by the Commiftee 4. The applicant must submit 1 original and 1 copy of the application, along with the same number of plans, to clearly indicate the following information: Boundaries of the lands which are the subject of the application Location, size and type of all existing and proposed buildings and structures on the subject land, indicating the set backs of the buildings and/or structures from the lot lines (front, rear, sides). Location of all natural and artificial features on the subject land and on abutting lands to the subject land that, in the opinion of the applicant, may affect the application, Examples include buildings, railways, roads, watercourses, drainage ditches, wetlands, wooded areas, wells and septic tanks. a Location and names of the existing highways, streets or roads abutting the lands ' Location and nature of any easement affecting the subject lands. Additional information regarding this application may be obtained by calling Susan Lankheit, Secretary-Treasurer, Committee of Adjustment, at (519) or , extension 2223 or slankheit@orangeville.ca

87 Broadway, Orangeville L9MKl Telephone (519) 941-0440 Ext. 2223 Toll Free Llne 1-866-941-0440 tr'ax (519) 94r-9033 TOWN OF ORANGEVILLE COMMITTEE OF ADJUSTMENT APPLICATION FOR D M NoR vartange s.

2 87 Broadway, Orangeville L9MKl Telephone (519) Ext Toll Free Llne tr'ax (519) 94r-9033 TOWN OF ORANGEVILLE COMMITTEE OF ADJUSTMENT APPLICATION FOR D M NoR vartange s.4s({) or tr speclal permtsston s.4s(2) (Under sect on 45 of the Planning Actlor relisf from Zoning By.law as amended) 1- Name of Owner Telephone Num Address 2. Name of Authorized Agent (if any)... Telephone Number... Address Note: Unless otherw-se requested, all communications will be sent to the agent, if any. 3. Names and addresses of any mortgagees, holders or charges or other encumþrances: 4. Nature and extent of relief applied for:

3 5. Why is it not possible to comply with the provisions of the by-law? 6. Legal description of subject land Plan Number/Concession Number Municipal Address 7 Dimensions of subject land: Frontage Depth Area Particulars of all buildings and structures on or proposed for the subject land: Existing Building/Structures on subject land: Type Front lot line setback Rear lot line setback Height Dimensions Date Gonstructed Slde lot line setback... Floor area Type Date Constructed Front lot line setback Rear lot line setback Height Dimensions Floor area

Proposed Buildings/Structures on subject land: 9. Type Front lot line setback Rear lot line setback Date Constructed Type Front lot line setback Rear lot line setback Date Constructed.

4 Proposed Buildings/Structures on subject land: 9. Type Front lot line setback Rear lot line setback Date Constructed Type Front lot line setback Rear lot line setback Date Constructed... Date of acquisition of subject land: Height Dimensions Floor area Height Dimensions Floor area 10. Existing uses of the subject property: 11. Length of time the existing uses of the subject property have continued: 12. Existing uses of abutting properties: 13. Municipal seryices available (check appropriate box or boxes): Water tr Connected Sanitary Sewers E Connected tr D Storm Sewers o 14, Present Official Plan designation applying to the land: 15. Present Zoning By-law provisions applying to the land:

o Yes n No o Unknown lf yes specify: File # Decision Relief File # Decision Relief Does the owner of this parcel own any adjacent parcels of land.

5 16. ls the subject property the subject of an application under the Planning Act, for approval of a plan of subdivision or consent? o Yes uno Fíle #.. Status 17 Has the subject property ever been the subject of an application for minor varíance? o Yes n No o Unknown lf yes specify: File # Decision Relief File # Decision Relief Does the owner of this parcel own any adjacent parcels of land. o Yes ono Signature of Applicant or Authorized Agent Dated atthe of this day of 2O-. IF THIS APPLICATION IS SIGNED BY AN AGENT, SOLICITOR OR ANY OTHER PERSON THAN THE OWNER OF THE SUBJECT LAND, WRITTEN AUTHORIZATION OF THE OWNER MUST ACCOMPANY THE APPLICATION. IF THE APPLICANT IS A GORPORATION, THE APPLICATION SHALL BE SIGNED BY AN OFFICER OF THE CORPORATION AND THE CORPORATION'S SEAL SHALL BE AFFIXED. NOTES: L It is required that 1 original and 1 copy of this application be filed with the Secretary- Treasurer of the Committee of Adjustment, together with the plan referred to, accompanied by a fee of $ in cash or by cheque made payable to the Treasurer of the Corporation of the Town of Orangeville. 2. The application must be accompanied by a plan showing the dimensíons 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 may require that the plan be signed by an Ontario Land Surveyor. Personal informatlon contained on thís form is collected pursuant to Section 45 the Planning Act, R.5.O.1990, c.p.13, and will be used for the purpose of respondíng to this application Quesúions should be directed to the Secretary-Treas.lrer, of the Committee of Adjustment at 87 Broadway, Orangeville, ON, LgW IKl. Telephone

TO BE SIGNED IN THE PRESENGE OF A COMMISSIONER FOR TAKINGAFFIDAVITS of the of solemnly declare that: in the of All the statements conlalned in this application are true and I make this solemn

6 TO BE SIGNED IN THE PRESENGE OF A COMMISSIONER FOR TAKINGAFFIDAVITS of the of solemnly declare that: in the of All the statements conlalned 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- DECI-ARED before me at the of in the.of Signature of Applicant 20 Signature of Commissioner, etc. *tnoterâ INFORMATION PROVIDED IN THIS APPLICATION WILL BECOME PART OF A PUBLIC RECORD

7 AUTHORIZATION OF OWNER l/la/e.(name of Owne(s)), hereby authorize (Name of person or agent authorized to sign application) to act as my Agent and sign the appllcation form to the Gommittee of Adjustment forthe Town of Orangeville, on my behalf, in respect to the premises known as (provide municipal address and legal description). Dated this day of 20 Signature of Owner(s) or Authorized Agent Per: Signature of Signing Office(s) and Corporation Seal, if applicable

PERMISSION TO ENTER Secretary-Treasurer Committee of Adjustment Town of Orangevílle 87 Broadway Orangeville, ON LgW 1K1 Re: Application to the Committee of Adjustment Municipal Address of Property:

8 PERMISSION TO ENTER Secretary-Treasurer Committee of Adjustment Town of Orangevílle 87 Broadway Orangeville, ON LgW 1K1 Re: Application to the Committee of Adjustment Municipal Address of Property: Legal Description of Property: lm/e herebyauthorize the members of the Committee of Adjustment and members of the staff of the Town of Orangeville to enter onto the above-noted property for the limited purposes of evaluating the merits of this application. Permission is also hereby given to permit a Notice of Hearing sign to be posted on the property in advance of the scheduled Hearing. Dated this day of,20 Per: Signature of Authorized Owne(s) or Agent Per: Signature of Signing Officer(s) and Corporation Seal, if applicable

9 COMMITTEE OF ADJUSTMENT SCHEDULED MEETING DATES FOR 2014 Time: 7 p.m. Meetinq Date JANUARY I Deadline Date for Submissions FEBRUARY 5 JANUARY 7 MARCH 5 FEBRUARY 4 APRIL 2 MARCH 4 MAY 7 APRIL I JUNE 4 MAY 6 JULY 2 JUNE 3 AUGUST 6 JULY 2 SEPTEMBER 3 AUGUST 5 OCTOBER 1 SEPTEMBER 2 NOVEMBER 5 OCTOBER 7 DECEMBER 3 NOVEMBER 4 JANUARY 7114 DECEMBER I

MINOR VARIANCE OR PERMISSION APPLICATION GUIDE

Box 5000, Station 'A' 200 Brady Street, Tom Davies Square Sudbury ON P3A 5P3 Tel. (705) 671-2489 Ext. 4376/4346 Fax (705) 673-2200 MINOR VARIANCE OR PERMISSION APPLICATION GUIDE APPLYING FOR A MINOR VARIANCE