Required fields are marked with asterisks (*)

Town of Fort Erie: Application For Consent/Severance Package

Under Subsection 2, Section 53 of the Planning Act R.S.O, 1990, c.P.13, as amended and other applicable legislation

Information on this form is collected under the authority of the Ontario Planning Act and will be used by the Town of Fort Erie in the processing of this application. The information as well as supporting studies and reports may be used by other departments and agencies for the purpose of assessing the proposal and preparing comments. This information may also be released to the public.

Planning and Development Services

The Corporation of the Town of Fort Erie

1 Municipal Centre Drive

Fort Erie, Ontario L2A 2S6

Applicants must submit the following completed check list with the consent application. Keep copies for your files.

Appointment Date and Time:

Section 1 - Property Location and Description

Municipal Address:

Legal description of the lands (Lot & Registered Plan or Concession):

Are there any easements or restrictive covenants affecting the subject land?

Yes

Section 2 - Pre-Consultation Requirements

Have you completed the formal pre-consultation agreement process?

Yes

Date of Pre-Consultation Agreement:

Section 3 - Historical Details

Has the subject land ever been the subject of an application for approval of a plan of subdivision or consent under the Planning Act?

Yes

Has this land ever been severed from the parcel originally acquired by the owner of the subject land?

Yes

Section 4 - Contact Information

(Applicants/agents may be a person or firm acting on behalf of the owner and will be required to submit an authorization form)
*If subject property is owned by a numbered company, please include the name of all principals as well.

Name of Applicant:

Company Name (if applicable):

Address:

Town/City:

Postal/Zip Code:

Telephone Number:

Cell Number:

Email Address:

Name of Agent (If different from the applicant):

Company Name (if applicable):

Address:

Town/City:

Postal/Zip Code:

Telephone Number:

Cell Number:

Email:

Name of Registered Owners(s) (if different from the applicant):

Address:

Town/City:

Postal/Zip Code:

Telephone Number:

Cell Number:

Email:

Main Point of Contact (this will be the person that will handle the file and liaise with the Town):

Company:

Please check yes if property owner should also be copied on all communication

Yes

Initial:

Section 5 - Application Details

Type and purpose of proposed transaction: (please check appropriate spaces)

creation of a new lot

disposal of surplus farm dwelling

partial discharge of mortgage (required if property is mortgaged)

farm retirement lot

addition to a lot (boundary adjustment)

lease

mortgage or charge

right-of way

easement

Other:

If applicable: name of person(s), to whom land or interest is to be transferred, leased or charged:

For a lot addition, please identify lands to which the parcel will be added:

For a lot addition, please indicate whether the lands to which the parcel will be added was the subject of a consent application:

Section 6 - Proposed Site Details

Description of Subject Lands: please indicate all measurements in metric

Severed Portion:

(As per part No. Shown on Consent Sketch)

Severed Part Number:

Frontage:

Depth:

Area:

Use of the Subject Lands: (ex. Residential, commercial, industrial)

Existing Use:

Proposed Use:

Building/Structure of the Subject Lands:

Existing:

Proposed:

Type of Access of the Subject Lands: (Please check appropriate space)

Provincial Highway

Regional Road

Municipal Road (year round maintained)

Municipal Road (seasonally maintained)

Other public road

Private road

Right-of-way

Water Access

What type of water is proposed: (please check appropriate space)

Publicly owned/operated piped water supply

Lake

Well (private or communal)

Other (Specify):

What type of sewage disposal is proposed: (please check appropriate space):

Publicly owned/operated sanitary sewage system

Septic system (private or communal)

Other (Specify):

Retained Portion:

(As per part No. Shown on Consent Sketch)

Retained Part Number:

Frontage:

Depth:

Area:

Use of the Subject Lands: (ex. Residential, commercial, industrial)

Existing Use:

Proposed Use:

Buildings/Structures of the Subject Lands:

Existing:

Proposed:

Type of Access of the Subject Lands: (please check appropriate space)

Provincial Highway

Regional Road

Municipal Road (year round maintained)

Municipal Road (seasonally maintained)

Other public road

Private road

Right-of-way

Water Access

What type of water is proposed: (please check appropriate space)

Publicly owned/operated piped water supply

Lake

Well (private or communal)

Other (Specify):

What type of sewage disposal is proposed: (please check appropriate space)

Publicly owned/operated sanitary sewage system

Septic system (private or communal)

Other (Specify):

Section 7 - Current Applications

Is the subject land currently the subject of a proposed official plan or official plan amendment that has been submitted to the Town for approval?:

Yes

Is the subject land currently the subject of an application for a zoning by-law amendment, Minister’s zoning order amendment, minor variance, consent or approval of a plan of subdivision?:

Yes

Section 8 - Other Information

Is there any other information that you think may be used by the Town or other agencies in reviewing this application? If so, please explain below or attach on a separate page

Section 9 - Provincial Plans and Significant Features Checklist

Feature or Development Circumstance

Potential Information Needs

Consistant with Provincial Policy Statement

Development or Special Feature

Yes

If feature, specify distance in metres

Development must be consistent

Consistent with the Growth Plan

Development or Special Feature

Yes

If feature, specify distance in metres

Development must be consistent

Non-Farm development near designated urban area or rural settlement area

Development or Special Feature

Yes

If feature, specify distance in metres

Demonstrate insufficient land supply available for development within the 20 year timeframe.

Class 1 Industry

Development or Special Feature

Yes

If feature, specify distance in metres

Assess development for residential and other sensitive land uses within 70 metres

Class 2 Industry

Development or Special Feature

Yes

If feature, specify distance in metres

Assess development for residential and other sensitive land uses within 300 metres

Class 3 Industry

Development or Special Feature

Yes

If feature, specify distance in metres

Assess development for residential and other sensitive land uses within 1000 metres.

Land Fill Site

Development or Special Feature

Yes

If feature, specify distance in metres

Address possible leachate, odor, vermin and other impacts.

Sewage Treatment Plant

Development or Special Feature

Yes

If feature, specify distance in metres

Asses the need for a feasivility study for residential and other sensitive land uses.

Waste Stabilization Pond

Development or Special Feature

Yes

If feature, specify distance in metres

Assess the need for a feasibility study for residential and other sensitive land uses.

Active Railway Line

Development or Special Feature

Yes

If feature, specify distance in metres

Evaluate impacts within 300 metres.

Controlled access highways including designated future routes.

Development or Special Feature

Yes

If feature, specify distance in metres

Evaluate impacts within 100 metres.

Agricultural operations

Development or Special Feature

Yes

If feature, specify distance in metres

Development to comply with the Minimum Distance Separation Formulae.

Existing Pits and Quarries

Development or Special Feature

Yes

If feature, specify distance in metres

Will development hinder continued operation or extraction.

Mineral and petroleum resource areas

Development or Special Feature

Yes

If feature, specify distance in metres

Will development hinder access to the resources or the establishment of new resource operations.

Provincially Significant Wetland

Development or Special Feature

Yes

If feature, specify distance in metres

No development is permitted.

Locally Significant Wetland or a Provincially Significant Wetland within 120 metres.

Development or Special Feature

Yes

If feature, specify distance in metres

An Enviromental Impact Study (EIS) must be prepared to determine impacts and mitagative measures.

Significant portions of habitat of endangered species and threatened species

Development or Special Feature

Yes

If feature, specify distance in metres

Development is not permitted.

Significant fish habitat, woodlands, valley land, areas of natural and scientific interest, wildlife habitat

Development or Special Feature

Yes

If feature, specify distance in metres

An Environmental Impact Study (EIS) must be prepared to determine impacts and mitagative measures.

Significant archeological resources

Development or Special Feature

Yes

If feature, specify distance in metres

Assess development proposed in areas of medium and high potential for significant archeological resources. See Official Plan Schedule D and D1.

Great Lakes System:

A-Within defined portions of the dynamic beach and 1:100 year flood levels along connecting channels

B-On lands subject to flooding erosion

Development or Special Feature

Yes

If feature, specify distance in metres

A-Development is not permitted.

B-Development may be permitted; demonstrate that hazards can be safely addressed

Note: it may be determined during the review of the application that additional studies or information will be required as a
result of issues arising during the processing of the application.

Class 1 Industry: small scale, self-contained plant, no outside storage, low probability of fugitive emissions and daytime
operations only.
Class 2 Industry: medium scale processing and manufacturing with outdoor storage, periodic output of emissions, shift
operations and daytime track traffic.
Class 3 Industry: processing and manufacturing with frequent and intense off site impacts and high probability of fugitive
emissions.

Declaration of Applicant or Authorized Agent

The following declaration must be signed by the applicant or agent in the presence of a commissioner for the talking of affidavits

I, (Name of Applicant or Authorized Agent)

of the (Town, City or Township)

in the (Region, County or District)

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 by virtue of THE CANADA EVIDENCE ACT.

Dated at the: (Town, City or Township)

in the (Region, County or District)

this date:

Signature of Applicant or Authorized Agent

Clear

Commissioner:

Declared before me at: (Town, City or Township)

in the (Region, County or District)

This date:

A Commissioner, etc.

Clear

Site Access Certificate

(to be signed by Owner(s))

I (we),

the registered owner(s)* of the below-noted lands hereby grant Town of Fort Erie staff, agencies and Members of a Town Committee to enter the subject site of (Address)

to review and confrim the information provided on this application.

Dated at: (Town, City or Township)

This date:

Please Print Name

Signature of Owner (AFFIX Corporate Seal if applicable)

Clear

Please Print Name

Signature of Owner (AFFIX Corporate Seal if applicable)

Clear

If subject property is owned by a numbered company, please include the principal owner(s) names as well.

Authorization to act on behalf of the owner

Authorization:

(Must be filled in if applicant and/or Agent is not the registered Owner of the lands)

I/We, being the registered owner(s) of the lands subject of this application hereby authorize (Name of Person)

of the Town/City of (Town, City or Township)

in the Regional Municipality of (Region, County or District)

to make application on my/our behalf to the Town of Fort Erie for a Consent/Severance in accordance
with Under Subsection 2, Section 53 of the Planning Act R.S.O, 1990, c.P.13 as amended.

Dated at the Town/City of (Town, City or Township)

in the Regional Municipality of (Region, County or District)

This date:

Owner signature

Clear

Witness signature

Clear

Owner Signature

Clear

Witness signature

Clear

Note: If the registered owner is a corporation, the corporate seal must be affixed to this form in addition to the signature of authorized signing officers.

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Town of Fort Erie: Application For Consent/Severance Package

Applicants must submit the following completed check list with the consent application. Keep copies for your files.

Section 1 - Property Location and Description

Section 2 - Pre-Consultation Requirements

Section 3 - Historical Details

Section 4 - Contact Information

Section 5 - Application Details

Section 6 - Proposed Site Details

Severed Portion:

Use of the Subject Lands: (ex. Residential, commercial, industrial)

Building/Structure of the Subject Lands:

Retained Portion:

Use of the Subject Lands: (ex. Residential, commercial, industrial)

Buildings/Structures of the Subject Lands:

Section 7 - Current Applications

Section 8 - Other Information

Section 9 - Provincial Plans and Significant Features Checklist

Declaration of Applicant or Authorized Agent

Commissioner:

Site Access Certificate

Authorization to act on behalf of the owner

Note: If the registered owner is a corporation, the corporate seal must be affixed to this form in addition to the signature of authorized signing officers.