planning application 2018 site plan approval application no.: · 2018-01-30 · additional...

PLANNING APPLICATION Planning Department, 2958 Greenfield Road, Ayr, ON N0B 1E0

2018 Site Plan Approval Application No.: ____________________

Pursuant to Section 41 of the Planning Act, RSO. 1990, as amended, an application for Site Plan Approval is hereby submitted, and enclosed are the plans and drawings (in metric), as per Township requirements, along with the processing Fee & refundable deposit.

Consultation with Township staff is required prior to submission of this application to discuss the development proposal and to determine what supporting documents and information may be required.

SUBMISSION CHECKLIST

Have you pre-consulted with Township Planning staff?

Township Application Fee(s)

Application Fee(s) when required by Region of Waterloo and/or GRCA to be submitted directly to these agencies:

Region of Waterloo Fees: http://www.regionofwaterloo.ca/en/doingBusiness/DevelopmentApplications.asp

GRCA Fees:

https://www.grandriver.ca/en/Planning-Development/Planning-Act-review-fees.aspx

1 original (double sided) of completed and signed application form

Written authorization by the Owner is required if the application is signed by an applicant, agent or solicitor on their behalf

Technical studies as required (e.g. Planning Justification Report)

Site plan drawings sorted and folded including at a minimum: - Building placement (existing/proposed), setbacks from property lines, parking and

loading, surface treatment of parking areas and loading areas - Engineering Drawings including existing conditions, site servicing, grading (existing

and proposed); overland drainage patterns and features; stormwater management; sediment and erosion control plan.

- Tree Preservation and Landscaping Plan - Illumination Plan including exterior lighting for walkways, parking, storage areas etc.

Contact Staff for number of copies required for application, survey, studies etc.

1 electronic pdf copy (flash drive) of all forms, technical reports, legal documents

Region of Waterloo Environmental Site Screening Questionnaire

Notice of Water Source Protection Plan Compliance (more information available at http://www.regionofwaterloo.ca/en/aboutTheEnvironment/sourceprotection.asp)

http://www.regionofwaterloo.ca/en/doingBusiness/DevelopmentApplications.asp

https://www.grandriver.ca/en/Planning-Development/Planning-Act-review-fees.aspx


The process of obtaining Planning Act approvals can be complex, for example to demonstrate compliance with provincial, regional and municipal policies. It may be in your best interest to engage the services of a Professional Consultants to ensure your application meets the applicable policies and to expedite the application process. Additional financial payments and costs may be required through the processing of an application, including, but not limited to, recirculation of applications, peer review of materials and/or information, agreements and associated fees. Fees and payments such as development charges, payment of outstanding taxes, securities, gratuitous conveyance of land for road widening, and Ontario Municipal Board appeals may be required. Please review the Township Fee Schedule By-law for more information.

TOWNSHIP FEES

Township fees related to processing a Site Plan application may include, but are not limited to the following (please consult the Township’s Fee Schedule By-law for more details):


2018 SITE PLAN APPLICATION FORM

PART A - PRE-CONSULTATION Pre-consultation is required prior to submitting an application. Has there been consultation with Township of North Dumfries staff prior to submitting this application? If yes, who did you consult with? Summary of matters raised at pre-consultation.

PART B – SITE ADDRESS AND LEGAL DESCRIPTION

Civic Address

Assessment Roll Number(s)

Lot/Block and Concession

Registered Plan Reference Plan

PART C – APPLICANT INFORMATION

Name and Address Phone / E-mail

Agent

Name:

Address:

City/Province:

Postal Code:

Phone:

E-mail:

Applicant

Name:

Address:

City/Province:

Postal Code:

Phone:

E-mail:

Registered Owner

Name:

Address:

City/Province:

Postal Code:

Phone:

E-mail:


PART D – SITE DETAILS

Frontage: Depth: Area:

Provide the following details for all structures and buildings on the subject:

Building/Structure #1



Description

Year Built

No. of Storeys

List all matters registered on title affecting the subject land(s), e.g. easements, agreements, restrictive covenants:

If known, the names and addresses of the holders of any mortgages, charges or other encumbrances in respect of the subject lands: Identify when the subject lands were acquired by the current owner:

Identify the current status of ownership of the subject lands by the applicant:

Identify any interests for lands which are adjoining or adjacent to the subject land(s) that form part of this application. Identify the address, location, and area of adjacent lands:

Have there been any previous Site Plan Approval or Development Agreements registered against these lands? If so, please provide details and attach.


Describe the existing and proposed land uses: Describe all existing buildings to remain and any new additions, buildings or structures proposed for the site:

Zoning By-law Requirements




Description

(use)

Existing or Proposed

If residential number of dwelling units

Ground Floor Area (sq m)

Gross Floor Area (sq m)

Number of Storeys

Dimensions (m)

Height (m)

Front Lot Line Setback (m)

Rear Lot Line Setback (m)

Side Yard Setbacks (m)

Parking

Total Building Coverage

Total Landscape Area for the Site

Outside Storage


What is the current Zoning and how does the proposed development conform to the Zoning By-law (e.g. permitted uses, setbacks, general regulations) Type of Water Supply:

a) a publicly owned and operated piped water system yes or no b) a privately owned and operated individual or communal well yes or no c) a lake or other water body yes or no d) another means, please explain _____________________________ yes or no

Type of Sewage Disposal System:

a) a publicly owned and operated piped sanitary sewage system yes or no b) a privately owned or operated individual or communal septic system yes or no c) a privy yes or no d) another means, please explain ______________________________ yes or no

Identify if the proposed amendment would allow development on a privately owned and operated individual or communal septic system where more than 4,500 litres of effluent would be produced per day ( yes or no) as a result of the development being completed (see Schedule 1-25 of OReg 545/06). If yes, answer Subsections ‘a’ and ‘b’:

a) Indicate whether a servicing options report has been submitted with the application: yes or no and list Title of Report/Author/Date

b) Indicate whether a hydrogeological report has been submitted with the application. yes or no and list Title of Report/Author/Date

Type of Storm Water Drainage System:

municipal sewer municipal ditch overland swale infiltration gallery dry well or by other _________________________________________________


How have Low Impact Development (LID) strategies been included? If they have not been included, how can the site plan be changed to incorporate LID?

Resources of Low Impact Development:

• http://conservationontario.ca/what-we-do/planning-regulations/sustainable-stormwater-planning

• http://www.sustainabletechnologies.ca/wp/home/urban-runoff-green-infrastructure/low-impact-development/low-impact-development-stormwater-management-planning-and-design-guide/

Status of Current and Other Applications under the Planning Act

Are the subject lands currently or in the past been the subject of an application under the Planning Act? If known, list File No.(s), status and/or decisions.

http://conservationontario.ca/what-we-do/planning-regulations/sustainable-stormwater-planning

http://conservationontario.ca/what-we-do/planning-regulations/sustainable-stormwater-planning


PART E – AUTHORIZATION

Registered Owner’s Authorization

The registered owner must complete the following, if the owner is not the applicant:

I, we,

being the Registered Owners of the subject lands, herby authorize,

to prepare and submit this application.

Signature(s):___________________________

Date:_________________________________

Note: If the owner is an incorporated company, the Company Seal shall be applied to this form.

Consent of the Owner to the Use and Disclosure of Personal Information:

I, __________________________________, am the owner of the land that is the subject of this application for consent and for the purposes of the Freedom and Information and Protection of Privacy Act. I authorize and consent to the use by, or the disclosure to, any person or public body of any personal information that is collected under the authority of the Planning Act for the purpose of processing this application.

Signature of Owner: Date:

____________________________________ ________________________________


PART F – AFFADAVIT OR SWORN DECLARATION I hereby swear that the information provided in this application is true.

______________________________ ______________________________

Date Submitted Signature of Owner(s)/Applicant (If applicant is signing, owner must complete Part H)

------------------------------------------------------------------------------------------------------------------------------

Sworn Declaration

I, ____________________________________ of the _______________________________

of _______________________________ in the Province of Ontario, 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.

Sworn before me at the

______________________________ of ________________________

in the Province of Ontario

this ______________ day of _________________20___ _________________________________ Signature of Owner or Authorized Agent

___________________________ a Commissioner, etc.

Stamp


PART G – TECHNICAL INFORMATION/STUDIES REQUIRED BY THE TOWNSHIP In determining the merits of the Planning Act Applications associated with your development proposal, Township staff must be consulted with to determine if any of the following technical documents are required to support the application to be considered as a complete application under the Planning Act.

Required Documentation: (It may be determined during the review of the formal application submission that additional studies or information is required as a result of issues arising during processing of the application. The applicant will be required to provide all technical studies and necessary information in addition to required peer review fees as part of the application at their expense).

a. Prescribed Application and Fees as per the Planning Act yes

b. Planning Justification Report yes

c. Urban/Civic Design Brief yes

d. Building Elevations and Renderings yes

e. Functional Engineering, Servicing & SWM Report Low Impact Development Brief

yes yes

f. Grading and Drainage Plan yes g. Sediment/Erosion Control Plan yes h. Landscaping, Tree Inventory and Preservation Plan (native species to be used in landscaping)

yes

i. Clean Water Section 59 Notice yes

j. Hydrogeological Report yes

k. Geotechnical/Soils Report yes

l. Environmental Impact Study yes

m. Floodplain Analysis yes

n. Demarcation of Top of Bank and other GRCA Regulated Areas yes o. Land Use Compatibility Assessment yes

p. Traffic Impact Analysis yes

q. Noise and Vibration Report yes

r. Record of Site Condition/Environmental Site Assessment yes

s. Agricultural Impact Assessment Report yes

t. MDS Compliance Report including calculations yes

u. Archaeological Assessment yes

v. Heritage Impact Assessment yes

w. Market Feasibility Study yes

x. Financial Impact Analysis yes

y. Draft Policies, Exemptions and/or Schedules yes

z. Other information: yes

Applicant / Owner / Agent Informed: Date

Method Informed by: TND Staff:


REGIONAL MUNICIPALITY OF WATERLOO

ENVIRONMENTAL SITE SCREENING QUESTIONNAIRE

This form must be completed by the property owner(s) for all development applications submitted to the Township of North Dumfries on behalf of the Regional Municipality of

Waterloo

1. Location of Subject Lands:

Municipal Address Legal Description

2. What are the current uses of the property?

3. Was the subject property ever used for industrial purposes? If YES, please describe approximate dates and types of industry:

4. Was the subject property ever used for commercial purposes where there is potential for site

contamination (i.e., automotive repair, gas station, dry cleaning operation, chemical

warehousing etc.)? If YES, please describe approximate dates and types of commercial

activity:

CORPORATION OF THE TOWNSHIP OF NORTH DUMFRIES 2958 Greenfield Road P.O. Box 1060 Ayr, Ontario NOB 1EO

Telephone: (519) 632-8800 Fax: (519) 632-8700

5. Has waste (garbage, solid wastes, liquid wastes) ever been placed on this property? If YES,

when? If YES, please provide description of waste materials:

6. Have hazardous materials ever been stored or generated on the property (e.g. has registration on the Hazardous Information Network or other permits been required?). If yes, please summarize details.

7. Is there reason to believe that this property may be potentially contaminated based on historical use of this property or an abutting property? If yes, please describe the nature of the suspected contamination.

8. Has the subject property or adjacent property ever been used as an agricultural operation where cyanide products may have been used as pesticides?

9. Are there or were there ever any above ground or underground storage tanks for fuels or chemicals on the property? If yes, please summarize the details.


14

10. Does the property have or ever had a water supply well, monitoring well, geothermal well? If yes, please provide details.

11. Does the property have or ever had a septic system?

12. Have any environmental documents been prepared or issued for this property, including but not limited to a Phase 1 environmental site assessment, risk assessment, Record of Site Condition or Certificate of Property Use?

13. Will lands be dedicated to the Region as part of this application (including road allowances, daylight triangles)?

14. DECLARATION OF PROPERTY OWNER(S)

I, am the registered owner of the land that is the subject of

this document and to the best of my knowledge, the information in this questionnaire is true.

DECLARED before me in the

Commissioner of Oath (Print Name) Municipality

This day of 20 .

Commissioner of Oath (signature) Registered Owner (signature)

Office Use

File No.:

planning application 2018 site plan approval application no.: · 2018-01-30 · additional...

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