City of Coquitlam Board of Variance Application City Clerk s Office 3000 Guildford Way, Coquitlam BC V3B 7N2 Tel: 604-927-3010 Fax: 604-927-3015 Instructions: If more information is required than a field allows for, please attach additional pages. If you have any questions about this application form or the procedures at the Board of Variance meeting please contact the City Clerk s Office at 604-927-3010. Applicant Information Name: Address: City: Postal Code: Phone: Fax: Email: Owner Information Owner Address and Postal Code Phone Email Property Description Property Address: Zoning: Legal Description: Date of Purchase: Project Description (Please detail the proposed construction project): Page 1 of 5
Variance Requested (Please detail the variance(s) to the Zoning Bylaw that you are requesting and the applicable section of the bylaw to be varied). Variance Requested Example: front yard setback from required 7.6 metres to 7.0 metres Zoning Bylaw Section Example: Section 1001(8)(a) Nature of Undue Hardship (Please detail the undue hardship that is the reason for your application, if there is not enough space below, please attach a separate sheet to the application and please be specific): Authorization of Applicant Please note, if you are not the Registered Owner of the property that requires Board of Variance approval, a letter signed by the owner is required prior to the Board of Variance meeting that allows you to act as a representative on his/her behalf. Neither Board members nor City staff are responsible for the completeness or accuracy of this application form. Please provide all the necessary information so that the Board members and City staff will be able to properly consider your request. I hereby designate Owners Name (Printed): to act as my agent in matters related to this application. Owners Signature: The Board of Variance operates pursuant to the regulations as established by Section 901 of the Local Government Act and Board of Variance Bylaw No. 4030, 2009 (a bylaw that provides for the establishment of a Board of Variance). Privacy Notice The personal information collected on this form is collected in accordance with the Freedom of Information and Protection of Privacy Act. The City has authority to collect your information for the purposes of administering the Board of Variance process in accordance with Section 899 of the Local Government Act. Applicants are advised that the Board of Variance process is public and any materials submitted become part of the public record and are available on request from the City Clerk s Office. Should you have any questions or concerns about the collection and/or release of your personal information please call Lauren Hewson, City Clerk s Office, at 604-927-3011. Page 2 of 5
Applicant Acknowledgement By signing this application form, the applicant/owner attests that the information provided on this and supplemental application forms for land use permits from the City of Coquitlam is true and correct to the best of their knowledge. Any material falsehood or any omission of a material fact made by the applicant/owner with respect to this application may result in an issued permit becoming null and void. I, the applicant/owner, certify that this application is being made with the full knowledge and consent of all owners of the property in question. Applicant or Authorized Representative Signature Date Office Use Only Information to be completed by City Staff Details of variances requested and the applicable section of the bylaw: Decision of the Board: Chairperson: Page 3 of 5
City of Coquitlam Board of Variance Checklist This checklist must be followed and submitted with your application form. If the application is incomplete it will affect the processing time of the pending application. City staff will review the checklist and application package. Only complete application packages will be accepted. Project Address: Forms, Fees and Technical Reports Document Required Details Application 1 A Board of Variance application form must be completed Form and signed at time of submission. Where the applicant is not the owner of the property written permission of the owner for the applicant to act on their behalf is required. Application Fee An application fee of $340.00 Notes Postal Code: (staff) Current Title Search 1 A copy of the current title search from the Land Title Office, including copies of any rights-of-way, restrictive covenants, easements, etc. that are registered on the title. Drawings Required Document Required Details Notes Certified 1 PID Survey Plan Legal Description Street address, street name(s) and location, location and width of any lane(s). Dimensions of site area. Location and dimensions of all existing buildings and structures on the site. Front, rear and side yard setbacks from buildings to lot lines. Lane dedications, registered easements, encroachments and rights-of-way. Location of existing street crossings. Existing grades at each corner of the lot(s) or spot elevations of the property at one metre intervals. Site Plan 2 (one full size and one 11X17) North arrow Date plan prepared. Street name(s) adjacent to and fronting the site Civic address of site Dimensions of site with property lines Location and dimensions of all buildings and structures including garages, sheds, gazebos etc. Variance request clearly identified and dimensioned. Existing and finished grade elevations. Location of the natural boundary of any existing watercourses or environmental features. Location of existing landscaping. Proposed structures should be labelled proposed. (Staff) Page 4 of 5
Drawings Required (continued) Document Required Details Notes Floor Plans 2 (one full Dimensioned at a scale not less than 1:100 or size and 1/8 =1 0. one 11X17) All storeys including with all outside dimensions of each floor. Indicate all room uses and dimensions, including finished/unfinished areas. All door, window and skylight locations. Clear indication of proposed work for additions to an existing building. Building Elevations 2 (one full size and one 11X17) Four elevations, front, rear and sides (indicating direction). Finished grade elevations around the perimeter of the structure. Finish details and materials of exterior including colours for proposed buildings and building additions. (Staff) I certify that the attached submission is complete and accurate, and includes all of the above items. Applicant Signature Date City Clerk s Office 3000 Guildford Way, Coquitlam BC V3B 7N2 Tel: 604-927-3010 Fax: 604-927-3015 Page 5 of 5