APPLICATION CHECKLIST (It is recommended that you consult with the Town s Planning and Development Department prior to submitting your application.) Please ensure you have completed the following prior to submitting your application: Fully complete all sections of the application. Sign application in all appropriate locations and obtain signed authorization from the Owner(s) if you are acting as their Agent. Declaration of Owner(s)/Agent must have a Commissioner s stamp and signature. Application fees attached made payable to the : o Major $2,000.00 + Initial Deposit $5,000.00 o Minor $500.00 + Initial Deposit $5,000.00 o Amendment to Site Plan Agreement $500.00 Supporting drawings (in metric) in accordance with the requirements of the application form. Digital copies of all drawings shall also be submitted to the Town in Adobe Acrobat.pdf format. Copy of any correspondence, approvals or permits from outside agencies / departments. Copy of any studies and reports required to be submitted with your application. Copy of Deed and any/all Mortgages. Copy of Survey. If you require additional assistance regarding this application, please contact the Department of Planning and Development at: 10 Robert Street West Penetanguishene, ON L9M 2G2 Ph: (705) 549-2673 Fax: (705) 549-3922 Site Plan Approval Checklist (2013)
OFFICE USE ONLY MAJOR MINOR AMENDMENT Date of Application: File Name: Civic Address: Application Complete: Yes No Fee Received: Yes No ROLL # 4372- - - - 0000 PRESCRIBED INFORMATION AND MATERIAL TO BE PROVIDED PURSUANT TO SECTION 41 OF THE PLANNING ACT, R.S.O. 1990. Pursuant to the Planning Act of Ontario, I/We submit an application for Site Plan Approval, the fee for which is non-refundable. Further details about the fees and deposits collected are detailed in the Municipal Costs Policy. 1. CONTACT INFORMATION: All communication will be directed to the Primary Contact only. Primary Contact: a) Registered Owner(s): (List all owners and contact information if multiple owners exist) Mailing Address: Home Phone: Business Phone: Cell Phone: Fax: Email Address: - Site Plan Approval Application Form (2013) 1 of 11
b) Applicant/Agent: Mailing Address: Home Phone: Business Phone: Cell Phone: Fax: Email Address: c) Solicitor (if applicable): Mailing Address: Home Phone: Business Phone: Cell Phone: Fax: Email Address: d) Engineer: Mailing Address: Home Phone: Business Phone: Cell Phone: Fax: Email Address: e) Names and current mailing addresses of any mortgagees, holders of charges or other encumbrancers: - Site Plan Approval Application Form (2013) 2 of 11
2. DESCRIPTION OF SUBJECT LANDS: a) Location Details Concession: Lot (s): Registered Plan: Lot #: Part (s): Reference Plan: Full legal description: Does the owner have an interest in, or own any adjoining lands which are not to be included in this application? If Yes, please describe the locations: b) Dimensions of subject lands: Frontage Depth Area (sq.m.) c) Dimensions of all buildings and structures: *Attach separate sheet if necessary. Existing: 1. Building/ Structure Ground Floor Area (m2) Gross Floor Area (m2) # of Stories Length Width Height 2. Proposed: 1. Building/ Structure Ground Floor Area (m2) Gross Floor Area (m2) # of Stories Length Width Height 2. - Site Plan Approval Application Form (2013) 3 of 11
d) Locations of all buildings and structures from lot lines. Note: The front lot line is defined as the shortest lot line abutting a street. *Attach separate sheet if necessary. Existing: 1. 2. Proposed: Building/ Structure Front Yard Interior Side Yard Exterior Side Yard Rear Yard 1. Building/ Structure Front Yard Interior Side Yard Exterior Side Yard Rear Yard 2. e) Are there any easements or rights-of-way affecting the subject lands? Yes No If yes, indicate and describe the purpose of the easement or right-of-way: f) Land Characteristics (check if applicable): Elevation High Hilly Low Marsh Other (specify) Type of Soil Clay Gravel Sand Rock Other (specify) - Site Plan Approval Application Form (2013) 4 of 11
3. EXISTING AND PROPOSED USES: a) Date the subject land was acquired by the current Owner: b) Existing uses of the subject land: c) Length of time that the existing uses have continued: d) Proposed uses of the subject land: *Attach a separate description if necessary e) What are the adjacent land uses: To the North: To the West: To the South: To the East: f) Official Plan Designation: g) Zoning: 4. ACCESS AND SERVICES: a) Access to the subject land is provided by: Provincial Highway County Road Municipal Road (year round) Municipal Road (seasonal) Private Road / Right-of-Way Water - Site Plan Approval Application Form (2013) 5 of 11
b) If access to the subject land is by water only, indicate the following: Provide written confirmation of parking and docking facilities. Docking facility: Distance from docking to subject land: Distance from docking to nearest public road: Parking facility: Distance from docking to parking: Distance from parking to nearest public road: c) Water is provided to the subject land by: Town water Private well Privately owned/operated communal well Lake or other water body Other: d) Sewage disposal is provided to the subject land by: Town sewer Private sewage system Privately owned/operated communal sewage system Other: e) Storm drainage is provided to the subject land by: Town storm sewers Ditches Swales Natural Other: - Site Plan Approval Application Form (2013) 6 of 11
5. SOUTHERN GEORGIAN BAY LAKE SIMCOE SOURCE PROTECTION PLAN: a) Is the subject land within a Wellhead Protection Area (WHPA) or an Issue Contributing Area (ICA)? Yes No b) If yes, please identify the WHPA/ICA? c) If yes, do you have an Approved Risk Management Plan (RMP) and/or a Section 59 Notice to Proceed from the Risk Management Official (RMO)? (Please attach the document you have). Yes No 6. OTHER APPLICATIONS: Indicate if the subject land is being submitted (or has been processed) as part of any other application(s) under the Planning Act: Consent Application Yes / No NoNonodsfiouerNoN Status Minor Variance Official Plan Amendment Zoning By-law Amendment 7. PLANS REQUIRED: Please attach six (6) copies of all drawings, drawn to scale in metric. One reduced copy (8.5 x 11 ) and a digital copy in Adobe Acrobat.pdf format must also be submitted. Minimum requirements will be a sketch showing the following: Key Map showing the location of the property. The boundaries and dimensions (frontage, depth and area) of the subject land. The location, size and type of all existing and proposed buildings and structures on the subject land and the location of all facilities and works to be provided, indicating the - Site Plan Approval Application Form (2013) 7 of 11
distance of the buildings or structures from the front lot line, rear lot line and the side lot lines. The location, widths and names of the existing streets or roads that abut the subject land, indicating whether an unopened road allowance, a public road, a private road or a right-of-way. Include any proposed widening of highways that abut the land (to be determined in discussion with road authority). The location of access ramps, driveways, etc. with widths, curve radii, medians, curbs, steps, etc. indicated and the proposed direction of traffic flow, where applicable. Walkways and walkway ramps and all other means of pedestrian access and barrier free access. The location and size of proposed parking area(s) and stalls, with dimensions and proposed surface marked thereon. Natural and artificial features (existing and proposed) such as pipelines, watercourses, drainage, ditches, swamps, and wooded area within or adjacent to the subject lands, as well as the location of any septic tank, tile bed or well. Any rights-of-way or easements, including easements conveyed to the Municipality for the construction, maintenance or improvement of watercourses, ditches, land drainage works, sanitary sewage facilities and other public utilities of the Municipality or local board thereof on the land. The slope of the land, in order to establish the relationship between the grade of abutting roads and the grade of the subject lands, and to determine the drainage of the land (this information to be given in the form of contours/spot elevations). Proposed stormwater management, including grading and alteration in elevation or contour of the land (i.e. any berms or buffers and provision for the disposal of storm, surface, and waste water from the land and from any buildings or structures). A stormwater management report may be required respecting quality and quantity. Drawing shall show minimum 10.0 m from property line. Vaults, central storage and collection areas and other facilities and enclosures for the storage of garbage and other waste material (including oil/grit interceptors, drywells). Facilities for the lighting, including location, type and shielding. Snow storage areas. Indicate scale, north arrow, and legend. Other required drawings: Landscape drawing(s) detailing walls, fences, hedges, trees (to be maintained and planted), shrubs or other groundcover or facilities for the landscaping of the lands or the protection of adjoining lands. Drawing(s) showing plan, elevation and cross-section views for each building to be erected, except a building to be used for residential purposes containing less than 25 - Site Plan Approval Application Form (2013) 8 of 11
dwelling units, sufficient to display: a) the massing and conceptual design of the proposed building; b) the relationship of the proposed building to adjacent buildings, streets, and exterior areas to which members of the public have access; c) the provision of interior walkways, stairs, elevators and escalators to which members of the public have access from streets, open spaces and interior walkways in adjacent buildings; d) matters relating to exterior design, including the character, scale, appearance and design features of buildings e) sustainable design elements, including trees, shrubs, hedges, plantings or other ground cover, permeable paving materials, street furniture, curb ramps, waste and recycling containers and bicycle parking facilities - Site Plan Approval Application Form (2013) 9 of 11
9. AUTHORIZATION BY OWNER: Applicable if an Agent is making this application on your behalf. If the Applicant is not the Owner of the subject land of this Application, the written authorization of the Owner stating that the Agent is authorized to make the Application on their behalf must be included with this application form or the authorization set out below must be completed. Please Note: If the Owner is an incorporated company, authorization of the appropriate signing officer(s) is required in accordance with the company s by-laws. I (we), Registered Owner(s) the undersigned, being the Registered Owner(s) of the subject land, hereby authorize Agent to act as my Agent with respect to the preparation and submission of this Application. Signature of Owner (If Corporation, I have the authority to bind the Corporation) Date 10. FREEDOM OF INFORMATION AND PRIVACY: Personal information contained in this form, collected and maintained pursuant to Section 45 of The Planning Act, will be used for the purpose of responding to the Application and creating a public record. The Owner s Signature acknowledges that personal information [is] collected and maintained specifically for the purpose of creating a record available to the general public; per Section 14(1)(c) of the Municipal Freedom of Information and Protection of Privacy Act, R.S.O. 1990, c. M. 56. The applicant acknowledges that the Town considers the application forms and all supporting materials, including studies and drawings, filed with this application to be public information and to form part of the public record. With the filing of an application, the applicant consents to the Town photocopying and releasing the application and any supporting material either for its own use in processing the application or at the request of a third party, without further notification to or permission from the applicant. The applicant also hereby states that it has authority to bind its consultants to the terms of this acknowledgement. Questions regarding the collection of information should be directed to the Department of Planning and Development at the Town of Penetanguishene at (705) 549-2673. Signature of Owner(s) Date Signature of Witness Date - Site Plan Approval Application Form (2013) 10 of 11
10. DECLARATION OF OWNER/AGENT: Must be signed by the Owner(s)/Agent in the presence of a Commissioner. I (Owner(s)/Agent) of the (Town/Township/City) of in the County/District/Regional Municipality of do solemnly declare that all of 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. Declared before me at the (Town/Township/City) of _in the County/District/Regional Municipality of this day of. Signature of Owner Signature of Agent (if applicable) Signature of Commissioner Commissioner s Stamp Please submit this application to the s Department of Planning and Development at: 10 Robert Street West Penetanguishene, ON L9M 2G2 Ph: (705) 549-2673 Fax: (705) 549-3922 - Site Plan Approval Application Form (2013) 11 of 11