APPLICATION FOR DEVELOPMENT PERMIT General Information

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General Information COMPLETE THE ATTACHED APPLICATION FORM by printing clearly or filling out all of the required fields electronically. The application must be signed by the registered owner(s) of the land if different from the applicant. Please note that electronic or digital signatures will not be accepted. INCLUDE A SITE PLAN drawn to scale showing: the legal description of the property; the parcel dimensions; the location and use of all existing and proposed buildings with distances from property boundaries; the location of any water bodies and other drainage courses, existing or proposed storm water drainage works, treed areas, shelter belts and other physical features of the land to be developed; the existing and/or proposed access to the property; all easements, right-of-ways, and adjacent roads; and site grading and drainage (indicated with directional arrows) if you are changing the site grade. A COPY OF THE PRIVATE SEWAGE DISPOSAL SYSTEM PERMIT issued by an accredited safety codes agency is required if the application is for the construction or location of a residence on the property. If an addition is planned to a residence, the County may require written confirmation from a safety codes agency that the existing sewage system is adequate for any proposed additions to a residence. A list of accredited agencies is provided on the attachment titled Compliance with Safety Codes Act. PHOTOGRAPHS are required to be submitted with any application for a moved-in building, including all preowned manufactured or mobile homes. These photographs are needed to consider the quality of the exterior appearance of the home or building, to ensure the exterior finishes and materials are in an acceptable condition. ALBERTA ENERGY REGULATOR (AER) DOCUMENTATION identifying the presence or absence of abandoned wells on the property must be provided with all development permit applications for buildings larger than 47 sq. m. (500 sq. ft) and for additions to buildings that will, as a result of the addition, become larger than 47 sq. m. (500 sq. ft.). This information can be obtained from the AER s Abandoned Well Viewer available on the AER website at www.aer.ca. If you do not have internet access, contact the AER Customer Contact Centre by telephone at 1-855- 297-8311 or by email at inquiries@aer.ca or contact Information Services by mail at AER, Suite 1000, 250 5 th Street SW, Calgary AB T2P 0R4. If it appears that a potential conflict between abandoned well locations and proposed surface development may exist, the proponent must contact the licensee on record for any additional information that may be required or to physically locate the well. A NON-REFUNDABLE PROCESSING FEE must also be paid. The current fee is $200 for most Development Permit Applications; however, a $500 fee is required for all commercial, industrial, gravel/sand pit, telecommunications towers and minor business and trades applications. All fees are payable to via cheque, cash or debit. MORE INFORMATION may be requested by the County to properly evaluate the application. RETURN THE APPLICATION TO RR 3 Lacombe AB T4L 2N3 planning@lacombecounty.com Page1

IMPORTANT NOTES No development shall be started until the County has issued a development permit. Where the proposed development is a permitted use and complies with the provisions of the County s Land Use Bylaw, a development permit will be issued as soon as a decision is made to approve the application. Neighbours do not have any right of appeal for a permitted use. Any decision made by the County on an application for a discretionary-use development or relaxation of one or more provisions of the Land Use Bylaw will be subject to appeal. If an application is refused, or the applicant or other party is not satisfied with one or more conditions of approval, then an appeal can be made to the County s Subdivision and Development Appeal Board (SDAB). The length of the appeal period is 21 days; if no appeals are received within this time period, the decision will be upheld by the County. If the decision was to approve the development, and there are no outstanding conditions of approval required to be completed prior to issuance, a development permit will normally be issued. If an appeal is filed against a decision, the application will be referred to the County s SDAB, who are required to schedule a hearing within 30 days of the date that the appeal was filed. The SDAB will then hear the application on its own merit and make a decision to approve or refuse the application. Should an approval be given, and there are no outstanding conditions of approval required to be completed prior to issuance, a development permit will be issued. Once a permit has been issued, the applicant(s) will have no more than 12 months from the date of issuance to commence the development described within the permit, and will have no more than 24 months from the date of issuance to complete the development. If the development described within the permit has not commenced within 12 months of the date of issuance, or the development has not been completed within 24 months, the permit may be declared null and void. Any request for an extension of these deadlines must be made in writing to the County; prior to the expiry of the 12 month deadline for development which has not commenced; and prior to the expiry of the 24 month deadline for development which has been commenced, but has not been completed. Once the development is started, it is not to be abandoned or left for an extended period of time in what the County considers to be an unsightly or unsafe condition. The development must be completed in accordance with the development approval. No changes or additions are to be made to the development without prior approval of the County. The permit does not excuse the applicant from complying with any other government regulations or requirements which may affect the development. For example: permits may be required under the Alberta Safety Codes Act before development can proceed. For more information, contact one of the accredited safety code agencies listed on the attachment titled Compliance with Safety Codes Act. a permit will be required from Alberta Transportation for any development that is proposed within 300 metres (984 feet) of a highway or within 800 metres (2625 feet) of an intersection of a highway with another public road. Before applying for a development permit, it is advisable to check with all oil/gas companies having an interest against the property for pipeline locations and restrictions affecting development near their facilities. Utility companies also need to be contacted prior to carrying out the development to ensure that buried utility lines are not impacted by the development. For further information about the development permitting process, please call the Planning and Development Department at (403) 782-8389. Page2

Application Form THIS FORM IS TO BE COMPLETED & SIGNED IN FULL, WHEREVER APPLICABLE, BY ALL REGISTERED OWNER(S) OF THE LAND AND/OR BY A PERSON AUTHORIZED TO ACT ON BEHALF OF THE LANDOWNER(S) 1. LANDOWNER INFORMATION Name of registered owner(s) of land Address Town Province Postal Code Home Phone Email Cell Phone How would you like to receive any correspondence relating to this application, such as the Notice of Decision and/or Development Permit? Original by mail OR Original by pick - up Copy by email 2. APPLICANT AUTHORIZED TO ACT ON BEHALF OF REGISTERED LANDOWNER(S) (If Applicable) Name of applicant(s) Address Town Province Postal Code Home Phone Cell Phone Email 3. LEGAL DESCRIPTION OF PROPERTY TO BE DEVELOPED All or Part of the 1/4 Sec. Twp. Range west of the Meridian NW / NE / SW / SE OR Being all parts of Lot Block Registered Plan No. Hamlet/Subdivision Name Civic Address Total Parcel Size 4. DEVELOPMENT INFORMATION Existing Use of Land Describe the Proposed Development This is a New Development OR This is an Existing Development For development that would result in residential occupancy, overnight accommodation or public facilities, please indicate if the development would be within 800 metres (or 0.8 kilometres) of: sour gas facility Yes No confined feeding operation Yes No landfill for the disposal of waste, waste Yes No processing site or waste transfer station wastewater treatment facility Yes No Page3

5. DETAILS OF PROPOSED DEVELOPMENT (If Applicable) Constructed on site OR Moved-in Building/Structure Type of Footings and/or Foundation Type of Structure Area Exterior Finish Height Estimated Construction Value $ For a Manufactured or Mobile Home, or Other Moved-in Building Make Year Serial Number: 6. CHANGES TO SITE GRADES Please indicate if any changes are proposed to the lot grades. Where changes are proposed, the County will require drawings showing the grade alterations. 7. OTHER COMMENTS ABOUT THE PROPOSED DEVELOPMENT, OR INFORMATION THE COUNTY NEEDS TO CONSIDER. Please indicate if there are any abandoned wells on the property as required by AER. 8. STATUS OF THE PROPOSED DEVELOPMENT Please indicate if any site work has been started on the proposed development. If so, specify the work done. You are advised that no further work on the development is to occur until a permit has been issued by the County. 9. SUPPORTING DOCUMENTS ATTACHED (If Applicable) Site Plan Copy of Private Sewage Disposal Permit Photographs AER Documentation Other (please specify) Page4

10. DECLARATION I/We declare that the information given on this form and accompanying plan(s) and other documents are to the best of our/my knowledge a true statement of facts concerning the proposed development. I/We also give my/our consent to allow a person appointed by the County the right to enter upon the said property with respect to this application only. I/We hereby consent to the public release and disclosure of all information contained within this application and supporting documentation as part of the development process. I/We hereby authorize the the Applicant(s) named in this application to act as Agent(s) on my/our behalf in the matter of development of the above-referenced lands. Registered Landowner Signature Registered Landowner Signature Applicant(s) Signature (If Different than the Registered Landowner) Applicant(s) Signature (If Different than the Registered Landowner) Please note that all information that you provide will be treated as public information in the course of Lacombe County s consideration of this development application pursuant to the Municipal Government Act, R.S.A. 2000 Chapter M-26 and the County s Land Use Bylaw. By signing this application, you consent to the public release of any information provided by you pursuant to this development. Information you provide will only be used for purposes related to the evaluation and consideration of this development application. If you have questions about this, please contact the FOIP Coordinator,, RR 3 Lacombe AB T4L 2N3 (403) 782-6601. THIS SPACE FOR OFFICE USE ONLY File No. Fee Paid Cash / Cheque / Debit Receipt No. File Assigned to 20 Day Deadline to Deem Complete/Incomplete Deemed Complete Yes / No If Deemed Incomplete, Deadline for Submission of Additional Information 40 Day Decision Deadline Land Use District Permitted / Discretionary ROLL NO. Additional Notes: Page5

Site Plan Below are the standard site plan requirements for all applications. If you wish to use an aerial photo to draw your site plan, please use Google Maps or contact the. Include the legal description of the property. Identify the parcel dimensions. Include the location and use of all existing and proposed buildings with distances from property boundaries. Identify the location of any water bodies and other drainage courses, existing or proposed storm water drainage works, treed areas, shelter belts and other physical features of the land to be developed. Identify the existing and/or proposed access to the property. Identify all easements, right-of-ways, and adjacent roads. Identify site grading and drainage (indicated with directional arrows) if you are changing the site grade. Indicate north on the site plan, and ensure all distance units are indicated. 22 metres 92 metres Existing House 36 metres Existing Access and Driveway Legal Description: 40 metres SW-17-39-02-W5M 2640 Range Road 804 metres 50 metres Proposed Garage 55 metres 20 metres 80 metres 800 metres Township Road Page6

Compliance with Safety Codes Act NOTICE: PERMITS FOR BUILDING, ELECTRICAL, PLUMBING, GAS AND PRIVATE SEWAGE DISPOSAL SYSTEMS The Safety Codes Act requires that all contractors and homeowners in Alberta obtain permits prior to commencing work on buildings covered by the Alberta Building Code or work governed by the Canadian Electrical Code, the Alberta Gas Code or the Alberta Plumbing Code. For more information on what permits may be required, contact one of the accredited safety service agencies listed below. In a non-accredited municipality, such as, permits are available through agencies who provide inspection services on behalf of the province through the Alberta Safety Codes Authority (ASCA). Aside from the legal requirement to obtain safety codes permits, the major benefits of obtaining a permit are knowing that the installation will conform to the safety standards that have been adopted under the Safety Codes Act, and that inspection(s) will be provided by certified safety codes officers. Services that you can normally expect to receive include: a permit, plans examination (if applicable), inspection(s) by certified safety codes officers, inspection report(s), follow-up of deficiencies and/or unsafe conditions, technical advice, and a status report at the completion of the project. Permit fees are established by each agency in a competitive market with maximum fee levels set by Municipal Affairs. AGENCIES AUTHORIZED BY ALBERTA MUNICIPAL AFFAIRS TO ISSUE PERMITS AND PROVIDE COMPLIANCE MONITORING IN NON-ACCREDITED MUNICIPALITIES AREA 7 Agency Name Phone Fax Canadian Safety Consulting IJD Inspections Ltd. (780) 897-1998 1-877-780-7233 (403) 346-6533 1-877-617-8776 (780) 539-7185 1-888-780-7232 Building Electrical Gas Plumbing Yes X X X (403) 347-2533 Yes Yes Yes Yes Marex Canada Ltd. 1-844-266-3123 (403) 261-0665 Yes Yes Yes Yes Park Enterprises Superior Safety Codes Inc. (Red Deer) (403) 329-3747 1-800-621-5440 1-888-358-5545 (403) 358-5545 (403) 329-8514 1-866-406-8484 1-866-358-5085 (403) 358-5085 Yes Yes Yes Yes Yes Yes Yes Yes The Inspections Group Inc. (780) 454-5048 1-866-554-5048 (780) 454-5222 1-866-454-5222 Yes Yes Yes Yes Page7