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Page 1: APPLICATION FOR CITY OF PORT COLBORNE FEASIBILTY STUDY …portcolborne.ca/fileBin/library/cb5e2764ef1d2913495ff9358763d851.pdf · APPLICATION FOR CITY OF PORT COLBORNE . FEASIBILTY

Revised October 19, 2010

City of Port Colborne Environmental Site Assessment

Grant Application Form

The Planning Act – Section 28

File No.: ______________ (Office Use Only)

APPLICATION FOR CITY OF PORT COLBORNE FEASIBILTY STUDY GRANT

This application form is to be used by persons wishing to apply for Community Improvement Plan funding for the incentive programs offered under the Brownfield Community Improvement Plan by the City of Port Colborne. The purpose of the Feasibility Study Grant Program is to promote the undertaking of project feasibility studies so that potential investors can obtain more and better information with respect to the costs of reusing, rehabilitating and retrofitting brownfield buildings and lands as well as the market/economic feasibility of undertaking different types of development. The Applicant is required to provide appropriate answers to all questions on the application form. If all prescribed information is not provided, the application will not be accepted. SUBMISSION OF APPLICATION: Please submit the completed application form and other information as set out herein to: City of Port Colborne Planning and Development Department Planning Division 66 Charlotte Street Port Colborne Ontario, L3K 3C8

Page 2: APPLICATION FOR CITY OF PORT COLBORNE FEASIBILTY STUDY …portcolborne.ca/fileBin/library/cb5e2764ef1d2913495ff9358763d851.pdf · APPLICATION FOR CITY OF PORT COLBORNE . FEASIBILTY

Revised October 19, 2010

City of Port Colborne Environmental Site Assessment

Grant Application Form

Part A: General Information and Instructions Before filling out this application, please read the attached Program Guide and arrange for a pre-application meeting with Staff. The Program Guide describes the purpose, basic terms and conditions of Feasibility Study Grant Program. 1. If the applicant is not the property owner, please ensure that written authorization from the property owner to make application for, conduct the environmental site assessment, and receive the grant is attached to the application form. 2. If an agent is acting for a property owner, please ensure that Form 1 (attached) is completed and signed by the owner. 3. If you find insufficient space on this form to respond to questions, please provide additional information on a separate page and attach to your completed application form. 4. Please attach to the application the required supporting documents as requested by City Staff.

An application will not be considered complete until all required documents have been submitted. 5. Please ensure that the application form is complete and that all required signatures have been supplied. 6. Please print (blue or black ink) or type the information requested on the application form. 7. You may deliver your application in person, or send it by mail to: City of Port Colborne Planning and Development Department 66 Charlotte Street Port Colborne Ontario, L3K 3C8 Attention: Lindsay Richardson, Community/Policy Planner 8. For more information, please contact Lindsay Richardson at 905-835-2901 ext 129, or via email at [email protected]. Details are also available on our website at http://www.portcolborne.ca/page/brownfields_CIP

Page 3: APPLICATION FOR CITY OF PORT COLBORNE FEASIBILTY STUDY …portcolborne.ca/fileBin/library/cb5e2764ef1d2913495ff9358763d851.pdf · APPLICATION FOR CITY OF PORT COLBORNE . FEASIBILTY

Revised October 19, 2010

City of Port Colborne Environmental Site Assessment

Grant Application Form

Part B: Application *PLEASE PRINT NEATLY* Section 3.0 to be completed by the environmental consultant (“Qualified Person”) 1. 0 APPLICANT INFORMATION

1.1 Registered Owner(s):

Mailing Address:

City: Province:

Postal Code: Telephone:

Fax: Email:

1.2 If the person/corporation apply for this grant is not the legally registered owner of the property for which the application is being made, please fill in the section below and attach written consent from the property owner to make this application, conduct the environmental site assessment and receive the grant. Name of Applicant: _________________________________________________ (If different from Registered Property Owner)

Mailing Address:

City: Province:

Postal Code: Telephone:

Fax: Email:

Page 4: APPLICATION FOR CITY OF PORT COLBORNE FEASIBILTY STUDY …portcolborne.ca/fileBin/library/cb5e2764ef1d2913495ff9358763d851.pdf · APPLICATION FOR CITY OF PORT COLBORNE . FEASIBILTY

Revised October 19, 2010

City of Port Colborne Environmental Site Assessment

Grant Application Form

1.3 If the property owner/application is authorizing an agent to act on his or her behalf in making this application, please complete Form 1, which attached to this application and provide the information requested below. If an agent is authorized, all correspondence will be sent to the authorized agent unless otherwise specified. If no agent is authorized, all correspondence will be sent to the property owner/applicant. Owner’s Authorized AGENT (if any):

Mailing Address:

City: Province:

Postal Code: Telephone:

Fax: __________________________________ Email:

Page 5: APPLICATION FOR CITY OF PORT COLBORNE FEASIBILTY STUDY …portcolborne.ca/fileBin/library/cb5e2764ef1d2913495ff9358763d851.pdf · APPLICATION FOR CITY OF PORT COLBORNE . FEASIBILTY

Revised October 19, 2010

City of Port Colborne Environmental Site Assessment

Grant Application Form

2.0 PROPERTY INFORMATION:

2.1 Address of Subject Property:

Legal Description (Lot and Plan No.):

Assessment Roll No.:

Current Uses:

Size of Property: ___________________________________________________

Is the property designated under Part IV Yes______ No______ of the Ontario Heritage Act?

Are there existing building(s) on the property? Yes______ No______

If yes, please specify size(s) below:

Building 1 _________________ sq ft Building 2 _________________ sq ft

Building 3 __________________ sq ft Building 4 _________________ sq ft

Is this property in tax arrears? Yes______ No______

If yes, please specify the value of tax arrears: $________________

Have the tax arrears been cancelled (in whole or in part) Yes______ No______ on this property under any City program?

Has or will this property receive grants/loans or other Yes______ No______ financial assistance from the City under any other City Programs?

Page 6: APPLICATION FOR CITY OF PORT COLBORNE FEASIBILTY STUDY …portcolborne.ca/fileBin/library/cb5e2764ef1d2913495ff9358763d851.pdf · APPLICATION FOR CITY OF PORT COLBORNE . FEASIBILTY

Revised October 19, 2010

City of Port Colborne Environmental Site Assessment

Grant Application Form

If yes, please specify program and amount of financial assistance received from the City ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Specify reason for conducting the above-noted project feasibility study on this property, including a description of the planned redevelopment/rehabilitation of the property being contemplated at this time, and any planning applications that have been submitted/approved. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Please note: Should this application involve more than one (1) parcel of land, the Owner shall provide the Legal Description and Assessment Roll No. for each parcel.

Page 7: APPLICATION FOR CITY OF PORT COLBORNE FEASIBILTY STUDY …portcolborne.ca/fileBin/library/cb5e2764ef1d2913495ff9358763d851.pdf · APPLICATION FOR CITY OF PORT COLBORNE . FEASIBILTY

Revised October 19, 2010

City of Port Colborne Environmental Site Assessment

Grant Application Form

3.0 Environmental Information (this section is to be completed by a Qualified Person as defined by the Environmental Protection Act and Ontario Regulation 153/04)

3.1 Name of Qualified Person: ___

Company Name: ___________________________________________________

Mailing Address:

City: Province:

Postal Code: Telephone:

Fax: __________________________________ Email:

Have any project feasibility studies been conducted on the property? If yes, please attach to this application.

Yes ______ No ______

This application for a Project Feasibility Study is for: Structural Analysis Evaluation of Mechanical and/or Electrical Systems Concept Plan Urban Design Study Market Analysis Other (please describe)

Estimated Cost of Feasibility Study (excluding H.S.T.)

$ ________________

Please attach a detailed work plan and cost estimate prepared by a qualified person for the project feasibility study being applied for

Page 8: APPLICATION FOR CITY OF PORT COLBORNE FEASIBILTY STUDY …portcolborne.ca/fileBin/library/cb5e2764ef1d2913495ff9358763d851.pdf · APPLICATION FOR CITY OF PORT COLBORNE . FEASIBILTY

Revised October 19, 2010

City of Port Colborne Environmental Site Assessment

Grant Application Form

4.0 Sworn Declaration I/WE HEREBY APPLY for a grant under this program. I/WE HEREBY AGREE to abide by the terms and conditions of the grant program. I/WE HEREBY CERTIFY that the information contained in this application is true, correct and complete in every respect and may be verified by the City by such inquiry as it deems appropriate, including inspection of the property for which this application is being made. I/WE HEREBY GRANT permission to the City, or its agents, to inspect my/our property that is subject of this application. I/WE HEREBY AGREE that if any statements or information in this application or submitted in support of this application are untrue, misleading or there is a material omission, the application may be rejected or not approved, or the grant may be delayed, reduced, cancelled or repayment of the grant may be required. I/WE HEREBY AGREE that the grant may be delayed, reduced or cancelled if the feasibility study is not completed, not completed as approved, or if the qualified professional conducting the study is not paid. I/WE HEREBY AGREE to provide the City with one (1) electronic copy and one (1) hard copy of the completed feasibility study for review. I/WE HEREBY AGREE that should I/WE chose not to proceed with the works contemplated in the feasibility study, the City may provide the feasibility study to a subsequent owner of the property. I/WE HEREBY AGREE that the program(s) for which application has been made herein is/are subject to cancellation and/or change at any time by the City in its sole discretion, subject to the terms and conditions specified in the program. I/WE HEREBY AGREE all grants/loans will be calculated and awarded in the sole discretion of the City. Notwithstanding any representation by or on behalf of the City, or any statement contained in the program, no right to any grant/loan arises until it has been duly authorized, subject to the applicant meeting the terms and conditions of the program and the grant/loan agreement. The City is not responsible for any costs incurred by the Owner/Applicant in any way relating to the program, including, without limitation, costs incurred in anticipation of a grant/loan. Dated at the ____________________, this ______ of _________________, __________ (City/Town of...) Day Month Year _______________________________________ ______________________________ Name of Owner/Applicant or Authorized Agent Signature of Owner/Applicant or Authorized Agent

CONSENT OF THE OWNER TO THE USE AND

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Revised October 19, 2010

City of Port Colborne Environmental Site Assessment

Grant Application Form

DISCLOSURE OF PERSONAL INFORMATION

Complete the consent of the owner concerning personal information set out below. I/we, am/are the owner(s) of the land that is subject of this application for the purposes of the Freedom of Information and Protection of Privacy Act, I/we authorize and consent to the use by or disclosure to any person or public body any personal information that is collected under the authority of the Planning Act for the purposes of processing this application. I/we, as the owner(s) of the land that is subject of this application, further acknowledge that I/WE DO NOT

have pecuniary interest whatsoever in the “Cost Estimates” as equired and provided with this application.

Signature of Owner(s) Date: Date: AFFIDAVIT I/We of the City/Town/Township of in the County/District/Regional Municipality of solemnly declare that all the statements contained in this application are true, and I/we 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 ) TO BE SIGNED IN THE PRESENCE OF A

) COMMISSIONER FOR TAKING AFFIDAVITS of )

) in the of ) ) This day of )

) A.D. 20 . )

(Signature of Owner or Authorized Agent) A Commissioner, etc.

Page 10: APPLICATION FOR CITY OF PORT COLBORNE FEASIBILTY STUDY …portcolborne.ca/fileBin/library/cb5e2764ef1d2913495ff9358763d851.pdf · APPLICATION FOR CITY OF PORT COLBORNE . FEASIBILTY

Revised October 19, 2010

City of Port Colborne Environmental Site Assessment

Grant Application Form

Form 1

AUTHORIZATION

LOCATION OF SUBJECT LANDS:

I/We, the undersigned, being the registered owner(s) of the above lands hereby authorize

of _______________________the of to make an application on my/our behalf to the Council or the Grant Review Committee for the City of Port Colborne for transaction concerning an application for Planning Fee Grant, Façade Improvement Grant, Sidewalk Café Grant, Applicant and Permit Fees Grant, Residential Intensification Grant, Sign Replacement Grant, Affordable Housing Grant, Shared Parking Grant, Parking Lot Improvement Grant (please circle the appropriate application) in accordance with the Planning Act. Dated at the of in the of this day of 200 Signature of Witness Signature of Owner Signature of Witness Signature of Owner Signature of Witness Signature of Owner This form is only to be used for applications which are to be signed by someone other than the owner or where more than one owner giving authorization to another owner. If the registered owner is a corporation, in addition to the signatures of the authorized signing officers, the corporate seal must be affixed. Where the Owner is without a spouse, common-law or legally married, the Owner is required to sign only once. Where the spouse of the Owner is not an owner, the spouse is required to sign. Spouse shall include a common-law spouse as defined within the Family Law Reform Act.

Page 11: APPLICATION FOR CITY OF PORT COLBORNE FEASIBILTY STUDY …portcolborne.ca/fileBin/library/cb5e2764ef1d2913495ff9358763d851.pdf · APPLICATION FOR CITY OF PORT COLBORNE . FEASIBILTY

Revised October 19, 2010

City of Port Colborne Feasibility Study Grant Program Guide

The Planning Act – Section 28

PROGRAM GUIDE FOR CITY OF PORT COLBORNE FEASIBILITY STUDY GRANT

This guide is to be used by persons wishing to apply for Community Improvement Plan funding for the incentive programs offered under the Brownfield Community Improvement Plan by the City of Port Colborne. Further Information: For more information regarding the Building Permit Fee Grant Program please contact: Lindsay Richardson, Community/Policy Planner Ph. 905-835-2901 ext 129 Fax. 905-835-2939 Email: [email protected]

Or visit our website at: http://www.portcolborne.ca/page/brownfields_CIP

Page 12: APPLICATION FOR CITY OF PORT COLBORNE FEASIBILTY STUDY …portcolborne.ca/fileBin/library/cb5e2764ef1d2913495ff9358763d851.pdf · APPLICATION FOR CITY OF PORT COLBORNE . FEASIBILTY

Revised October 19, 2010

City of Port Colborne Feasibility Study Grant Program Guide

Program Description The purpose of the Feasibility Study Grant Program is to provide a financial incentive in the form of a grant to help offset the cost of conducting feasibility studies on brownfield buildings and lands in the Community Improvement Project Area. This will help provide property owners, potential developers and investors with more and better information with respect to the feasibility and cost of reusing, rehabilitating and retrofitting buildings and properties. Frequently Asked Questions (FAQs) 1. Who can apply? Owners of properties with existing buildings and vacant properties (and non-owners with written authorization from owners) within the Urban Area of the City of Port Colborne that meet the program eligibility requirements may apply. The City retains the right and absolute discretion to reject an application received from a person or corporation which in the option of the City or its professional advisers, does not possess the experience, financial, technical, personnel or other resources that may be required to carry out the obligations that the applicant proposes to assume under the terms of its application 2. How does the program work? The program is a 50-50 matching grant program where the City of Port Colborne will provide a grant to an applicant for up to 50% of the cost of an eligible feasibility study (excluding H.S.T.) to a maximum grant of $7,500 per feasibility study, with a maximum of one (1) feasibility study per property/project. 3. What types of studies are eligible for funding? Eligible feasibility studies included, but are not limited to: Structural analyses; Evaluation of existing and proposed mechanical, electrical and other building systems; Conceptual plans; Urban design studies; Market analyses; and Any other feasibility study as approved by the City

4. What conditions must be met to be eligible for a grant? Applications must be made in writing and approved by the City prior to the

commencement of the project feasibility study and must be accompanied by: Detailed work plan and cost estimate for the eligible feasibility study, prepared by

a qualified professional as determined by the City; Description of the planned redevelopment, including any planning applications

that have been submitted/approved; and Where the applicant is not the owner of the property, written consent from the

owner of the property confirming that the applicant may make the application, All feasibility studies that are subject of the Feasibility Study Grant program shall be

completed by a qualified professional as determined by the City.

Page 13: APPLICATION FOR CITY OF PORT COLBORNE FEASIBILTY STUDY …portcolborne.ca/fileBin/library/cb5e2764ef1d2913495ff9358763d851.pdf · APPLICATION FOR CITY OF PORT COLBORNE . FEASIBILTY

Revised October 19, 2010

City of Port Colborne Feasibility Study Grant Program Guide

All completed project feasibility studies must comply with the description of the study as provided in the grant application form.

One (1) electronic and one (1) hard copy of the study shall be submitted to the City for review. You must agree to provide the City with permission to provide the study to a subsequent owner(s) of the property should you decide not to proceed with the work that is subject of the feasibility study.

Actual costs for any or all items eligible for a grant may be subject to audit by the City, at the expense of the applicant.

Where other sources of government and/or non-profit organization funding (Federal, Provincial, Municipal, CMHC, Federation of Canadian Municipalities, etc...) that can be applied against the eligible costs are anticipated or have been secured, these must be declared as part of the Application. Accordingly, the amount of the incentive provided by the City may be reduced on a pro-rated basis.

City Staff, officials and/or agents of the City may inspect any property that is the subject of an application.

5. Is there a fee to apply? No. 6. How do I apply for a grant? In order to apply for the Feasibility Study Grant Program you must first arrange a pre-application meeting with Staff in order to determine program eligibility, proposed scope of work, project time etc. Once you have done this, and Staff is satisfied that you can proceed you will be required to complete and submit an application. Please ensure that all required signatures have been provided and that the application is accompanied by all required documentation as shown in the Required Documents List. 7. What happens next? Applications and supporting documentation are reviewed by Staff to ensure that they

meet all of the eligibility requirements. Staff may request clarification or additional supporting documentation. Staff will perform an initial site visit(s) and inspection(s) of the property (in necessary). A decision on the application is made by Staff and you will be notified of the decision in

writing. If your application is approved, you will receive a grant approval letter specifying the

amount of the grant and the requirements that must be met in order to receive payment of the grant. If your application is not approved you will receive a letter advising you of this.

Once you have received the City’s approval letter, the feasibility study may commence. Contact City Staff when the study is completed. Submit to the City one (1) electronic and one (1) hard copy of the study and a copy of an

invoice(s) showing that the study has been paid for in full. The actual grant amount will be calculated based on 50% of the original cost estimate for

the study or 50% of the actual cost of the study, whichever is less. Upon review and approval of all submitted documentation, the City will issue a grant

cheque to the application for the full amount of the approved funding.

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Revised October 19, 2010

City of Port Colborne Feasibility Study Grant Program Guide

The application will be asked to complete a grant receipt from and return this to the City. The City reserves the right to audit the cost of the project feasibility study prior to

advancing the grant payment. For further information on this program please contact Lindsay Richardson at 905-835-2901 ext 129 or via email at [email protected].