CORPORATION OF THE TOWNSHIP OF NORTH DUMFRIES 2958 Greenfield Road P.O. Box 1060 Ayr, Ontario NOB 1EO Telephone: (519) 632-8800 Fax: (519) 632-8700 Site Plan Approval Application No.: Pursuant to Section 41 of the Planning Act, RSO. 1990, as amended, an application for Site Plan Approval is hereby submitted, and enclosed are the plans and drawings (in metric), as per Township requirements, along with the processing Fee & refundable deposit. Consultation with Township staff is required prior to submission of this application to discuss the development proposal and to determine what supporting documents and information may be required. SUBMISSION CHECKLIST Have you pre-consulted with Township Planning staff? Township Application Fee(s) including Peer Review Fees See details on next page Application Fee(s) when required by Region of Waterloo and/or GRCA to be submitted directly to these agencies Region of Waterloo Fees: http://www.regionofwaterloo.ca/en/doingbusiness/developmentapplications.asp GRCA Fees: https://www.grandriver.ca/en/planning-development/planning-act-review-fees.aspx Original copy (double sided) of completed and signed application form Written authorization by the Owner is required if the application is signed by an applicant, agent or solicitor on their behalf Copies of site plans (folded and sorted) including at a minimum: - Building placement; buildings (existing/proposed) setbacks from property lines; benchmark grades (existing/proposed); parking; surface treatment of parking areas and loading areas - Site Servicing illustrating site grading (existing and proposed); overland drainage pattern and features; any on-site storage; and an opinion letter from a qualified individual identifying pre and post development flows; location of any septic bed. A stormwater management report may be required. - Landscaping Plan - Illumination Plan including exterior lighting for walkways, parking, storage areas etc. Technical studies as required (e.g. Planning Justification Report); check with staff on the number of copies required Contact Staff for number of copies required for application, survey, studies etc. Electronic pdf copy (flash drive) of all forms, technical reports, legal documents Region of Waterloo Environmental Site Screening Questionnaire Notice of Water Source Protection Plan Compliance (more information available at http://www.regionofwaterloo.ca/en/abouttheenvironment/sourceprotection.asp)
The process of obtaining Planning Act approvals can be complex, for example to demonstrate compliance with provincial, regional and municipal policies. It may be in your best interest to engage the services of a Planning Consultant to ensure your application meets the applicable policies and to expedite the application process. Additional financial payments and costs may be required through the processing of an application, including, but not limited to, recirculation of applications, peer review of materials and/or information, agreements and associated fees. Fees and payments such as development charges, payment of outstanding taxes, securities, gratuitous conveyance of land for road widening, and Ontario Municipal Board appeals may be required. Please review the Township Fee Schedule By-law for more information. It may be determined during the review of the formal application submission that technical studies and/or information are required as a result of issues arising during the processing of the application. The applicant will be required to provide all technical studies and necessary information in addition to peer review fees as part of the application at their expense. TOWNSHIP FEES Township fees related to processing a Site Plan application may include, but are not limited to the following (please consult the Township s Fee Schedule By-law for more details): The Applicant will provide a Refundable Deposit with the submission of a Site Plan Application. This Deposit will be held on account by the Township to cover expenses associated with peer review or technical services for Legal, Engineering, Transportation, Hydrogeology, Environmental Sciences, Geotechnical, Noise & Vibration, Landscape Architecture and Urban Design disciplines (and other similar services), and, the Administration Processing Fee. Once all payments have been completed and the file is closed out, the residual of the Deposit Account will be refunded to the Applicant. In the Site Plan Agreement, the Township will secure as cash a Refundable Deposit. The Township will pay out all inspection fees & disbursements incurred by the Municipality through expenses associated with the Township's Legal, Engineering and/or Landscaped Architecture consultants associated with the discharge of their duties as outlined in the Agreement, and, Staff's time associated with the administration of the Agreement. The Township shall also levy an Administration Processing Fee against all Legal and consultant services expenditures which shall be drawn from the Refundable Deposit Account. Upon all financial obligations and requirements as set out in the Agreement being completed to the satisfaction of the Township, the residual funds held in the Deposit Account shall be refunded to the Applicant. 2
SITE PLAN APPLICATION FORM PART A - PRE-CONSULTATION Pre-consultation is required prior to submitting an application. Has there been consultation with Township of North Dumfries staff prior to submitting this application? If yes, who did you consult with? Summary of matters raised at pre-consultation. PART B SITE ADDRESS AND LEGAL DESCRIPTION Civic Address Assessment Roll Number(s) Lot/Block and Concession Registered Plan Reference Plan PART C APPLICANT INFORMATION Name and Address Phone / E-mail Agent Applicant Registered Owner Name: Address: City/Province: Postal Code: Name: Address: City/Province: Postal Code: Name: Address: City/Province: Postal Code: Phone: E-mail: Phone: E-mail: Phone: E-mail: 3
PART D SITE DETAILS Frontage: Depth: Area: Provide the following details for all structures and buildings on the subject: Description Building/Structure #1 Building/Structure #2 Building/Structure #3 Year Built No. of Storeys List all matters registered on title affecting the subject land(s), e.g. easements, agreements, restrictive covenants: If known, the names and addresses of the holders of any mortgages, charges or other encumbrances in respect of the subject lands: Identify when the subject lands were acquired by the current owner: Identify the current status of ownership of the subject lands by the applicant: Identify any interests for lands which are adjoining or adjacent to the subject land(s) that form part of this application. Identify the address, location, and area of adjacent lands: 4
Have there been any previous Site Plan Approval or Development Agreements registered against these lands? If so, please provide details and attach. Describe in detail the existing and proposed land uses: Describe all existing buildings to remain and any new additions, buildings or structures proposed for the site: Description (use) Zoning By-law Requirements Building/Structure #1 Building/Structure #2 Building/Structure #3 Existing or Proposed If residential number of dwelling units Ground Floor Area (sq m) Gross Floor Area (sq m) Number of Storeys Dimensions (m) Height (m) Front Lot Line Setback (m) 5
Rear Lot Line Setback (m) Side Yard Setbacks (m) Parking Total Building Coverage Total Landscape Area for the Site Outside Storage What is the current Zoning and how does the proposed development conform to the Zoning By-law (e.g. permitted uses, setbacks, general regulations) Type of Water Supply: a) a publicly owned and operated piped water system yes or no b) a privately owned and operated individual or communal well yes or no c) a lake or other water body yes or no d) another means, please explain yes or no Type of Sewage Disposal System: a) a publicly owned and operated piped sanitary sewage system yes or no b) a privately owned or operated individual or communal septic system yes or no c) a privy yes or no d) another means, please explain yes or no Identify if the proposed amendment would allow development on a privately owned and operated individual or communal septic system where more than 4,500 litres of effluent would be produced per day ( yes or no) as a result of the development being completed (see Schedule 1-25 of OReg 545/06). If yes, answer Subsections a and b : 6
a) Indicate whether a servicing options report has been submitted with the application: yes or no and list Title of Report/Author/Date b) Indicate whether a hydrogeological report has been submitted with the application. yes or no and list Title of Report/Author/Date Type of Storm Water Drainage System: municipal sewer municipal ditch overland swale infiltration gallery dry well or by other How have Low Impact Development (LID) strategies been included? If they have not been included, how can the site plan be changed to incorporate LID? Resources of Low Impact Development: http://conservationontario.ca/what-we-do/planning-regulations/sustainable-stormwaterplanning http://www.sustainabletechnologies.ca/wp/home/urban-runoff-green-infrastructure/lowimpact-development/low-impact-development-stormwater-management-planning-anddesign-guide/ 7
PART E LAND USE PLANNING REVIEW Land Use Criteria 1. Are the subject lands located in an area of land designated in any provincial plan (e.g. Greenbelt, Growth Plan for the Greater Golden Horseshoe)? If yes, identify which plans, applicable designations and policies. Explain how the proposal does or does not conform to the provincial plan. 2. Is the proposal consistent with the Provincial Policy Statement (PPS)? Explain how the application is consistent with the PPS. 3. How are the subject lands designated in the Region of Waterloo Official Plan? Does the proposal conform to the official plan designations and policies? Please explain. 4. Is the site located within a Source Water Protection Area? Notices and more information can be obtained from the Region of Waterloo s TAPS Website at www.regionofwaterloo.ca/sourceprotection 5. How is the land designated in the Township of North Dumfries Official Plan? Does the proposal conform to the Official Plan designations and policies? Please explain. 6. Do the existing and proposed development have frontage on a public road? 7. Is the site regulated by Grand River Conservation Authority? If yes, the Owner is responsible for obtaining all necessary approvals. Description on How the Proposal Conforms/Does Not Conform or if N/A 8
8. Are there any existing natural features on or adjacent to the subject lands? Wetlands, forests or trees, fish habitat Valley lands, erosion hazards, floodplains Wildlife habitat, endangered or threatened species habitat Areas of natural and scientific interest Groundwater recharge areas, headwaters or aquifers Potential for linkages between existing natural features How will the proposed development maintain, enhance and protect natural features including natural heritage linkages? 9. Has the Guelph District of the Ministry of Natural Resources and Forestry been contacted to determine the potential presence of species at risk? 10. Does the subject land contain or is it located within 300 m of any known or potential areas of archaeological resources? See MTCS website at http://www.mtc.gov.on.ca/en/archaeology/a rchaeology_assessments.shtml for screening criteria including a check list. 11. Does the subject land contain or is it located within 100 m of any known or potential cultural heritage resources? See t http://www.mtc.gov.on.ca/en/heritage/tools. shtml for screening criteria including a check list. 12. Is the site located on a Regional or Provincial Road 13. Does the proposal conform to the provincial Minimum Distance Separation Formulae? Please list all livestock, manure facilities and anaerobic digesters within 750 m of the property (include type, amount of livestock) 14. Is there an active railway line within 300 m? 9
15. How is the proposed development compatible with the surrounding neighbourhood? Density, scale, height Massing, visual impact, architectural character Preservation of natural features Landscaping, setbacks Noise, dust, emissions or odours Traffic generated Site lighting to minimize glare and impact to nigh sky Status of Current and Other Applications under the Planning Act Are the subject lands currently or in the past been the subject of an application under the Planning Act? If known, list File No.(s), status and/or decisions. 10
PART F AUTHORIZATION Registered Owner s Authorization The registered owner must complete the following, if the owner is not the applicant: I, we, being the Registered Owners of the subject lands, herby authorize, to prepare and submit this application. Signature(s): Date: Note: If the owner is an incorporated company, the Company Seal shall be applied to this form. Consent of the Owner to the Use and Disclosure of Personal Information: I,, am the owner of the land that is the subject of this application for consent and for the purposes of the Freedom and 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 purpose of processing this application. Signature of Owner: Date: 11
PART G AFFADAVIT OR SWORN DECLARATION I hereby swear that the information provided in this application is true. Date Submitted Signature of Owner(s)/Applicant (If applicant is signing, owner must complete Part H) ------------------------------------------------------------------------------------------------------------------------------ Sworn Declaration I, of the of in the Province of Ontario, 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 ACT. Sworn before me at the of in the Province of Ontario this day of 20 Signature of Owner or Authorized Agent a Commissioner, etc. Stamp 12
PART H TECHNICAL INFORMATION/STUDIES REQUIRED BY THE TOWNSHIP In determining the merits of the Planning Act Applications associated with your development proposal, the Township may request the following documents to be prepared to address the matters of Provincial and Municipal Interest. Required Documentation: (It may be determined during the review of the formal application submission that additional studies or information is required as a result of issues arising during processing of the application. The applicant will be required to provide all technical studies and necessary information in addition to required peer review fees as part of the application at their expense). a. Prescribed Application and Fees as per the Planning Act yes b. Planning Justification Report yes c. Urban/Civic Design Brief yes d. Building Elevations and Renderings yes e. Functional Engineering, Servicing & SWM Report Low Impact Development Brief yes yes f. Grading and Drainage Plan yes g. Sediment/Erosion Control Plan yes h. Landscaping, Tree Inventory and Preservation Plan yes (native species to be used in landscaping) i. Clean Water Section 59 Notice yes j. Hydrogeological Report yes k. Geotechnical/Soils Report yes l. Environmental Impact Study yes m. Floodplain Analysis yes n. Demarcation of Top of Bank and other GRCA Regulated Areas yes o. Land Use Compatibility Assessment yes p. Traffic Impact Analysis yes q. Noise and Vibration Report yes r. Record of Site Condition/Environmental Site Assessment yes s. Agricultural Impact Assessment Report yes t. MDS Compliance Report including calculations yes u. Archaeological Assessment yes v. Heritage Impact Assessment yes w. Market Feasibility Study yes x. Financial Impact Analysis yes y. Draft Policies, Exemptions and/or Schedules yes z. Other information: yes Applicant / Owner / Agent Informed: Method Informed by: Date: TND Staff: 13