Application to Amend a Statutory Plan and/or the Land Use Bylaw

Where applicable, this application is to be completed in full by the registered owner of the land or by an authorized person acting on behalf of the owner. Please meet with the Planning and Development Department prior to submitting your application.

STATEMENT OF INTENT

I/We,

First Last

hereby make application to amend Bylow No.

Untitled

Intermunicipal Development Plan

Municipal Development Plan No. 2017-06

Land Use Bylaw No. 2019-06

APPLICANT INFORMATION

Applicant

Company

Email Address

Telephone

Alternate Telephone

Mailing Address

Street Address Town Province Postal Code

Registered Owner (if applicant is other than owner)

Company

Email Address

Telephone

Alternate Telephone

Mailing Address

Street Address Town Province Postal Code

AMENDMENT PROPOSAL

Map or Text Amendment

Map Amendment

Text Amendment

Map Amendment Information

Civic Address or General Location of Land:

Legal Description

Lot/Block/Plan or Quarter/Section/Twp/Range

Certificate of Title:

Please attach a copy of the certificate of title.

Redistricting Proposal (if applicable)

Current land use district

Proposed land use district

Proposal

Rationale for proposal

Please attach additional information as required to support the application. Please describe the conformity of the proposed change to the County’s Intermunicipal and Municipal Development Plans, as well as any relevant Area Structure Plan.

Text Amendment Information

Proposal

Rationale for proposal

Upload Attachments

Drop files here or

Max. file size: 256 MB.

RIGHT OF ENTRY

I/We,

First Last

give consent to allow a person(s) designated by the Countythe right to enter and inspect the above land and/or building(s) with respect to this application only.

Signature

Date

CERTIFICATION AND SIGNATURE

Registered owner or person acting on their behalf

I, hereby certify that Ia) am the registered owner or b) am authorized to act on behalf of the registered owner(s), and that the information given on the form is complete and is, to the best of my knowledge, a true statement of the facts relating to this application.

Applicant’s Signature

Date

This information is being collected under authority of sections 33(a) and (c) of the Freedom of Information and Protection ofPrivacy Act. Your personal information will be used to process your application(s). Please be advised that your name, address, anddetails related to your permit may be included on reports that are available to the public as required or allowed by legislations. All personal information will be managed in compliance with the provisions of the FOIP Act. Questions about thecollection of this information can be directed to the Director of Corporate Services 780-694-3793.