APPLICATION FOR SITE PLAN CONTROL for applying under Section 41 of the Planning Act, R.S.O. 1990, CHAPTER P. 13 (as amended)

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for applying under Section 41 of the Planning Act, R.S.O. 1990, CHAPTER P. 13 (as amended) APPLICATION: It is the responsibility of the Owner or Authorized Agent to provide complete and accurate information at all times. This form will not be accepted as a complete application until such time as all questions have been answered and all requirements have been met in the manner requested herein. PRE- CONSULTATION: Application fees Any person wishing to submit an application for site plan control is required to attend a preconsultation meeting with the Planning Department and members of various departments. The meetings occur twice a month. Call the Planning Department to set up a time to review the project. FEES Residential Base Fee: $115/dwelling unit; Minimum $1,000 Non-Residential Base Fee: $1,000 Due Upon submitting application Sign fees Deposit South Nation fees Site Plan Agreement fees When an application requires public notice, a sign describing the proposal must be posted on the subject property. The fee for this sign is charged in addition to the above application fees: $280.00 for Large Sign $85.00 for Small Sign Additional signage, if required, will be invoiced to the applicant at real cost. Applicants are required to pay for, and install signage on the subject property in accordance with the Planning Department s Sign guidelines. Following the submission of a complete application, signs will be prepared and ordered by the Township and the applicant will be notified when they are ready for pickup. Signs must remain well-maintained on the property until the application has been approved. $1,000.00 deposit for Minor Plans and Studies Review and Final Inspection (where the estimated cost of site works is less than $15,000 as verified by the Township engineer); OR $3,000.00 deposit for Major Plans and Studies Review and Final Inspection (where the estimated cost of site works is $15,000or greater as verified by the Township engineer). 1. Municipal services, < 0.5 ha in size: $360 2. Municipal services, 0.5 to < 2.0 ha in size: $605 3. Municipal services, > 2 ha to < 5 ha in size: $975 4. Municipal services, > 5 ha in size: $2,445 5. Private services, < 5 ha in size: $975 6. Private services, > 5 ha in size: $2,445 20% of the Base Application Fee for Planning Administration Fee 10% of the Base Application Fee for Township Administration Fee $625.00 + HST for Legal Fees (registration of the agreement) Letter of Credit (50% of total cost) Upon submitting application Upon submitting application SNC fees due upon submission of application (Separate check made out to SNC) Upon signature of the agreement Page 1 of 12

OWNERSHIP: AUTHORIZATION: PUBLIC INFORMATION: PLANS: COMMISSIONERS SIGNATURES: Proof of ownership is to accompany each application. If more than one owner is shown therein, the application shall be submitted under all names, and all parties are required to sign either the application form or authorization form. All agents MUST file an authorization form signed by ALL REGISTERED OWNERS when filing on their behalf. All information submitted with this application will be made available to the public at the. Refer to the submission requirements detailed within the application. All documents and drawings must be submitted on a USB key in Adobe PDF format in addition to the hard copy requirements described below. All full-sized plans MUST BE folded to a maximum size of 8½ x 11. All required documents and drawings must be submitted for the application to be considered complete. It is required that this form be signed before a Commissioner of Oaths. If more than one owner is shown therein, ALL OWNERS are required to sign before a Commissioner; otherwise, an authorization form will be necessary. A commissioner is available at the front counter of the first floor Planning Department. CANCELLATION OF A SITE PLAN CONTROL APPLICATION, SITE PLAN CONTROL AMENDMENT APPLICATION, SUBDIVISION APPLICATION, OR CONDOMINIUM APPLICATION: Before preparation of the public notification: 80% of the Base Application Fee (does not include Engineering Plans and Studies Review and Work Surveillance costs, administration, legal or inspection fees), 100% of the Sign Fee, and 100% of the deposit shall be returned if a request is received by the Planning Department prior to preparation of the public notification (sign) and before review of the application has begun. After review of the application has begun: The Base Application Fee and Sign Fee are non-refundable. The deposit shall be refunded based on a cost recovery basis; Engineering Plans and Studies Review and Work Surveillance costs, and other costs for legal, administrative, and/or inspection fees incurred prior to the request for cancellation shall be recovered and any remaining balance will be refunded to the applicant. Any outstanding balance, if the costs incurred exceed the deposit amount, must be paid by the applicant within 30 days of written notice of the outstanding balance. If a request is received prior to preparation of a Site Plan Agreement or Site Plan Amendment Agreement no Township Administrative Fees, Planning Administrative Fees or legal fees (for the cost of registering the agreement) will be charged. After preparation of the Site Plan Agreement or Site Plan Amendment Agreement: The Base Application Fee and Sign Fee are non-refundable. The deposit shall be refunded based on a cost recovery basis; Engineering Plans and Studies Review and Work Surveillance costs, the Township Administrative Fees, the Planning Administration Fees and other costs for legal, administrative, and/or inspection fees incurred prior to the request for cancellation shall be recovered and any remaining balance will be refunded to the applicant. Any outstanding balance, if the costs incurred exceed the deposit amount, must be paid by the applicant within 30 days of written notice of the outstanding balance. If you have any questions regarding your application, call the Planning Department at 613-443-3066 or by fax at 613-443-1042. Page 2 of 12

Application No. Receipt No. Report No. APPLICATION FOR SITE PLAN CONTROL for applying under Section 41 of the Plnning Act, R.S.O. 1990, CHAPTER P. 13 (as amended) HAVE YOU PRE-CONSULTED WITH THE PLANNING DEPARTMENT? HAVE YOU CONSIDERED DEVELOPMENT CHARGES? Complete all applicable sections of the application form. An incomplete application will be returned to the applicant. All required studies and plans must be part of the submission package for the application to be considered complete. SECTION 1: BACKGROUND INFORMATION PROPERTY INFORMATION Address: Unit: Registered Plan Number: Lot/Block numbers: Roll Number: Concession Have you pre-consulted with Township staff? Yes No If yes, indicate the date of pre-consultation: Current zoning: Indicate the name of the staff member: REGISTERED PROPERTY OWNER INFORMATION Last Name: First Name: Position: Corporation or Partership: Address: Unit: Town: Province: Postal Code Phone: Cell: Email:

APPLICANT INFORMATION Registered Owner: Authorized Agent: Last Name: First Name: Position: Corporation or Partnership: Address: Unit: Town: Province: Postal Code: Phone: Fax: E-Mail: Specify the person or group of persons who is/are to receive the Township s comments following the revision of the plans. (email address) Name: Phone: Name: Phone: Name: Email: Cell: Email: Cell: Email: Phone: Cell: APPLICATION TYPE (CHECK ONE) New / Addition to Industrial, Commercial, Institutional, and Mixed Use Buildings New / Addition to Residential Buildings (townhouses, low profile apartments, planned unit development, etc.) New / Addition to parking area Amendment to an existing Site Plan Agreement Other (communications facility, recreational commercial use, etc.) Specify: Has the subject property been the subject of previous development applications (zoning, consent, minor variance, subdivision, etc.)? Yes No Don t know If yes, provide previous file number(s) and the date of any application(s): File # Date: File # Date: What is the current use of the land? What is the current Official Plan designation of the subject property? What is the current Zoning of the subject property? Page 4 of 12

Lot characteristics: Lot frontage (m): Lot area (m2): Lot depth (m): or lot area (if irregular (m2): SECTION 2: PROPOSAL DETAILS What type of development proposed (new buildings or additions, land use(s), number of unit(s), proposed tenure, etc.)? What is your anticipated date for start of construction? What is your anticipated date for end of construction? Is the proposed project to be phased? Yes No If Yes, specify the proposed phasing schedule: Phase Number Units/Phase Estimated Start Date Estimated Completion Date Will the roadway be modified because of this proposal? Yes No If Yes, note that you may be required to obtain a road cut permit and/or permission to create a new entrance onto a roadway from the appropriate authority. Page 5 of 12

Development Information What is the gross floor area of all proposed buildings/additions (m2)? What is the gross floor area of all existing buildings (m2)? What is the proposed total gross floor area (m 2 )? What is the proposed commercial gross floor area (m 2 )? What is the proposed number of residential dwelling units? What is the proposed industrial gross floor area (m 2 )? What is the maximum building height proposed? How many storeys are proposed? How many total combined parking spaces are to be provided (existing + proposed)? How many total barrier-free parking spaces are to be provided (existing + proposed)? How many total loading spaces are to be provided (existing + proposed)? What is the proposed lot coverage (total area of all building footprints divided by total lot area x 100) (%)? What percentage of the total site will be occupied by vegetation and landscaping (total area of all landscaping and vegetation divided by lot area x 100) (%)? How many existing trees will be removed from the site? Outdoor Patio Information (if applicable) What is the area of the proposed patio (m 2 )? What is the gross floor area of the existing restaurant (m 2 )? What is the distance to the nearest residential zone (m)? Telecommunications Tower Requirements (if applicable) What is the height of the proposed tower (m)? What is the gross floor area of all structures (m 2 )? What is the area of the leased/fenced site (m 2 )? Site Servicing (please check all that apply): Existing Proposed Existing Proposed Municipal Water Storm Sewer Sanitary Sewer Private Well Private Septic Communal Septic Site Access (please check one): Provincial Highway Right of Way Other Public Road County Road Page 6 of 12

SECTION 3: ESTIMATED COSTS FOR SITE IMPROVEMENTS Indicate the estimated costs of all site improvements (excluding building and land costs). A Letter of Credit or cheque deposit for 50% of the total estimated cost of site works is required prior to the execution of the Site Plan Agreement. All cost estimates will be reviewed and adjusted as necessary by the Township Engineering Consultant. 1. Sodding, Seeding and/or Topsoil 2. Planting (trees and shrubs) 3. Fencing and Retaining Walls 4. Asphalt/Gravel (driveways, parking and loading areas, etc.) 5. Concrete Curbs 6. Sidewalks, Walkways and Ramps 7. Site Lighting 8. Garbage Vault or Collection Area Enclosure 9. Water Service and Connection 10. Sanitary Sewers and Connection 11. Storm Drainage Facilities 12. Road Widening and/or Road Cuts 13. Signs (barrier-free parking, fire routes, etc.) TOTAL Page 7 of 12

SECTION 4: SUBMISSION REQUIREMENTS Submission and plan requirements are outlined for the applicant during pre-application consultation with Township Staff. It is highly recommended that you consult with the Township prior to submission to ensure that your application is complete and is processed in a timely manner. Requirements for All Submissions: Number of Copies Required Plans package including: 3 full size copies - Site Plan 3 reductions (11 x17 ) - Landscape Plan - Grade Control and Drainage Plan - Site Servicing Plan Site Survey 2 copies (11 x 17 ) Potentially Required Studies (requirements to be defined through pre-consultation): Engineering: Traffic Impact Study Site Servicing Study Stormwater Management Report Composite Utility Plan Geotechnical Study/Slope Stability Study Groundwater Impact Study Erosion and Sediment Control Plan Hydrogeological and Terrain Analysis Noise/Vibration Study Planning/Design: Planning Rationale Architectural Elevation Drawings Concept Plan Showing Ultimate plan for Lands Plan of Parking Garage Layout Minimum Distance Separation (MDS) Archaeological Study Sun Shadow Study Environmental: Phase 1 Environmental Site Assessment Phase 2 Environmental Site Assessment Tree Conservation Report Impact Assessment of Adjacent Waste Disposal/Former Landfill Site Mineral Resource Impact Assessment Environmental Impact Assessment Page 8 of 12

Notes: 1. All full-size plans and drawings must be submitted on A1-sized paper and folded to 8½ x 11. 2. Note that many of the plans and studies collected with this application must be signed, sealed, and dated by a qualified engineer, architect, surveyor, planner, or design specialist. The plans will not be reviewed if this information is missing. 3. Electronic copies of all required studies and plans must be supplied on a USB key in Adobe PDF (.pdf) format. Ensure that the key accompanies your application submission. 4. The applicant is responsible for paying for, and installing signage, as required by the Township, on the subject property. Signs will be ordered and the applicant notified when they are ready for pickup. 5. Additional fees may be required throughout the development review process, including, but not limited to, parkland dedication, review of technical reports, Conservation Authority fees, agreements and associated fees, applicable securities and inspection fees. 6. Upon completion of the project, before release of the securities, the applicant is responsible for providing one (1) 8.5 x 10 mylar copy and one (1) full size copy of each as-built plan. The applicant is also responsible for submitting an electronic PDF (.pdf) copy of the as-built plans. CONSENT I/we consent and authorize representatives of the and those persons identified under the Planning act R.S.O., 1990 c., P13, to enter upon the land subject to this application for the purpose of conducting any site inspections and take pictures as may be necessary for the evaluation of this application. Signature of the Applicant/Authorized agent Print name Date Page 9 of 12

AUTHORIZATION OF OWNER(S) If someone other than the registered owner(s) of the property is making this application, then this section must be completed. If there is more than one registered owner, separate authorization is required from each individual or corporation. I/We, the undersigned, hereby authorize (print full name, including company, if any) to submit the enclosed application to the Corporation of the, and to appear on my/our behalf at any hearing(s) of the application, and further, to provide any information or materials required by the relevant to the application. DECLARED BEFORE ME at the (town, city, village, etc.) of (Embrun, Limoges, Marionville, Russell) this day of, (Day of the month) (Month) (Year) Signature of Owner(s) Signature of Owner(s) A Commissioner, etc. Page 10 of 12

DECLARATION This section is to be completed by the person carrying out this application (i.e. the registered property owner or the authorized applicant). Note that if the applicant is not the registered owner, the Authorization of Owners form must also be completed. I, of the (name) (town, city, village, etc.) of, (Embrun, Limoges, Marionville, Russell, etc.) 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. DECLARED BEFORE ME at the (town, city, village, etc.) of (Embrun, Limoges, Marionville, Russell, etc.) this day of, (Day of the month) (Month) (Year) Signature of Authorized Applicant(s) or Owner(s) Signature of Authorized Applicant(s) or Owner(s) A Commissioner, etc. Page 11 of 12