Township Of Tiny Committee Of Adjustment

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Township of Tiny Committee of AdjustmentGUIDELINES FOR SUBMITTING A MINOR VARIANCE APPLICATIONPre-consultationPrior to filing this application, the applicant is encouraged to consult with the Township PlanningDepartment with respect to the variances requested. In addition, pre-consultation with the Countyof Simcoe Planning Department and Tatham Engineering Limited (Township sewage approvalagent) or other agencies that may be involved in reviewing the application and their requirementsis recommended.Submission Checklist1 copy of the completed application form signed in the presence of a Commissioner ofOaths. If the application is being completed and submitted by an agent, an Owner’sAuthorization (Appendix 1) must be completed and signed by the owner(s).2 copies of the sketch or survey to scale.The required 1,200.00 application fee.Application feesThe application fee (noted above) can be paid by cash/debit or cheque payable to “TheCorporation of the Township of Tiny”.Supporting documentationTo assist in reviewing the application, please attach and submit electronically any supportingdocumentation (i.e. surveys, technical/planning reports, elevation drawings, photographs, etc.).Submit Application and Questions to:smattson@tiny.caSecretary-Treasurer, Committee of AdjustmentPlanning DepartmentTel: (705) 526-4204Attendance at Public MeetingThe owner, applicant or agent should attend the Committee of Adjustment Public Meeting and beprepared to respond to any questions or concerns the Committee or public may have regardingthe application. The Public Meeting for the application may be adjourned to another date if noone is present to represent it, or the Committee may make a decision in your absence. Arescheduling/recirculation fee may be charged.AgendaThe Committee of Adjustment Agenda will be available on the Township’s website at www.tiny.caprior to the Public Meeting. The Agenda will include the Application (and all supportingdocuments), Notice of Public Meeting, Planning Report and any comments received.Planning\COMADJ\ApplicationsRevised April 27, 2022

130 Balm Beach Road WestTiny, Ontario L0L 2J0(705) 526-4204 1-866-939-8469www.tiny.caAPPLICATION FOR VARIANCE OR FOR PERMISSIONThe following information and material is to be provided in an application underSection 45 of the Planning Act, R.S.O. 1990, c.P. 13 as amended:FOR OFFICE USE ONLYApplication: ARoll No.:Date Received:/Subject Property:Date Complete:1. Owner(s) InformationName of Owner(s):Mailing Address:Home Phone No.:Business Phone No.:Email Address:Postal Code:Cell No.:Note: If owner is a corporation, please provide copy of articles of incorporation.2. Agent / Applicant InformationAn owner’s authorization is required if the applicant is not the owner (Appendix 1).Name of Agent:Mailing Address:Home Phone No.:Business Phone No.:Email Address:Postal Code:Cell No.:3. Source Water ProtectionIs the subject property within Well Head Protection Area (WHPA)?NoYesIf yes, please complete the Source Protection Plan Pre-Authorized Screening Form(Appendix 2). Please note, that this application may be delayed and/or refused if theproposed development offends the Source Protection Plan for the South Georgian BayLake Simcoe Source Protection Region. If the application requires detailed review by theSevern Sound Environmental Associations (SSEA), the Risk Management Office, adeposit of 240.00 is required to cover such costs.

Township of TinyMinor Variance ApplicationPage 2 of 74. Basis of ApplicationNature and extent of relief applied from the Zoning By-law:What is the required zone standard for a setback/lot coverage/height, etc. and what is theproposed zone standard? Example: The Zoning By-law requires a front yard setback of 8metres and the proposed front yard setback is 6 metres.Why is it not possible to comply with the provisions of the Zoning By-law?5. Property Descriptiona) Legal Description of Subject Land:Township Lot:Registered Plan:Reference Plan:Municipal Address:Concession:Lot:Part(s):b) Dimensions of land affected (metres/hectares):Frontage:Width of Street:Depth:Lot Area:c) Particulars of all buildings and structures, existing or proposed, for the subject land(specify ground floor area, gross floor area, number of stories, width, length, dthlgthht

Township of TinyMinor Variance ApplicationPage 3 of 7d) Location of all buildings and structures on or proposed for the subject land (specifydistance from side, rear and front lot lines) (metres). (If lot fronts onto Georgian Bay, 178metre elevation GSC is to be identified with 15 & 45 metre setbacks):SideRearFrontExisting:Proposed:6. Property HistoryDate of acquisition of subject land:Date of construction of all buildings and structures on subject land:Building/Structure:Date:7. Property UseExisting uses of the subject property (e.g. residential, commercial, etc.):Proposed uses of the subject property (e.g. residential, commercial, etc.):Length of time the existing uses of the property have continued:8. Municipal ServicesRoad Access (please check appropriate space(s)):Municipal Road maintained year round maintained seasonallyProvincial HighwayCounty RoadPrivate RoadRight-of-WayWater Access178 metre

Township of TinyMinor Variance ApplicationPage 4 of 7Describe the parking and docking facilities to be used and the approximate distance ofthese facilities from the subject land and the nearest public road:Water Supply (please check appropriate space(s)):Publicly owned & operated communal systemPrivately owned & operated communal wellPrivate owned & operated individual wellLake or other water bodydugdrilledSewage Disposal (please check appropriate space(s)):Privately owned & operated sewage system (specify class of system):Class I (Privy)Class II (Grey Water System)Class III (Cesspool)Class IV (Septic System)Class V (Holding Tank)Other (please describe)Storm Drainage (please check appropriate space(s)):Municipal sewersOpen ditchesSwales9. Official Plan and Zoning InformationPresent County of Simcoe Official Plan designation applying to the land:Present Township of Tiny Official Plan designation applying to the land:Present Zoning By-law provision(s) applying to the land:10. Planning Historya) Has the subject land ever been subject to a Minor Variance Application under Section 45of the Planning Act, R.S.O. 1990, Chapter P.13, as amended?YesNoPrevious Application No.: AIf the answer is yes, describe briefly:/

Township of TinyMinor Variance ApplicationPage 5 of 7b) Is the subject land the subject of a current application for plan of subdivision or consentunder Section 53 of the Planning Act, R.S.O. 1990, Chapter P. 13, as amended?YesNoIf the answer is yes, describe briefly:11. Required SketchThe application shall be accompanied by a sketch to scale showing the following:i.ii.iii.iv.v.vi.vii.The boundaries and dimensions of the subject land;The location, size and type of all existing and proposed buildings and structures onthe subject land, indicating the distance of the buildings or structures from the frontyard lot line, rear yard lot line and the side yard lot lines;The approximate location of all natural and artificial features on the subject land andon land that is adjacent to the subject land that, in the opinion of the applicant, mayaffect the application. Examples include buildings, railways, roads, watercourses,drainage ditches, river or stream banks, wetlands, wooded areas, wells and septictanks;The current uses on land that is adjacent to the subject land;The location, width and name of any roads within or abutting the subject land,indicating whether it is an unopened road allowance, a public travelled road, a privateroad or a right of way;If access to the subject land is by water only, the location of the parking and dockingfacilities to be used; andThe location and nature of any easement affecting the subject land.Notwithstanding the foregoing, the Committee of Adjustment reserves the right to require thesubmission of a plan of survey prepared and certified by an Ontario Land Surveyor.12. Cost Acknowledgement AgreementIf application is being made by an agent, please disregard this section as it captured in theowner’s authorization (Appendix 1).In consideration of the Township of Tiny receiving this application;The Owner represents that he/she is/are the registered owner(s) of the lands described inthis application; andThe Owner recognizes that there may be a number of legal, planning, engineering, andenvironmental issues to be investigated and resolved which may necessitate time and efforton the part of both the Owner and the Township; andThe Township may find it necessary to engage professional services in consideration of theproposal; andThe Owner, in consideration of the associated professional services, hereby agrees asfollows:

Township of TinyMinor Variance ApplicationPage 6 of 71. In this agreement, “expenses” means all professional services and/or consultant’s feesand disbursements.2. The Township agrees to review the application and if necessary retain such additionallegal, planning, engineering, and environmental consultants as are necessary to properlyevaluate the application.3. The Owner shall submit with the application the required municipal administration fee,which does not account for additional costs of associated professional services.4. The Owner agrees to be responsible for and agrees to reimburse the Township for allexpenses the Township may have incurred in respect of the application.5. As expenses are incurred by the Township, the Township shall pay the invoice(s) andsubmit an invoice to the Owner of the disbursements at which time the invoice(s) is to bepaid within 30 days.6. In the event that the invoice(s) remains outstanding for more than 30 days, the Townshipmay halt all work in respect of the application until all arrears are satisfied.7. The Owner may withdraw this application at any time, however, shall be responsible forthe costs incurred up to the date that the Township of Tiny receives written notice ofwithdrawal of the application.8. This Agreement shall not be construed as acceptance or approval by the Township ofthe application.IN WITNESSETH HEREOF the owner(s) hereto has/have executed this agreement thisday of, 20 .(Signature of Owner)(Signature of Owner)TO BE COMPLETED BY COMMISSIONER OF OATHS OR NOTARY PUBLIC:Municipality Declaration Administered:Date of Declaration:Signature of Commissioner of Oathsor Notary Public:Commissioner of Oaths Stampor Notary Seal:13. Consent of the Owner(s)If application is being made by an agent, please disregard this section as it captured inthe owner’s authorization (Appendix 1).Consent of the Owner(s) to theUse and Disclosure of Personal InformationI/We,, am/are the owner(s) of theland that is the subject of this application and for the purposes of the Freedom of Informationand Protection of Privacy Act, I/we authorize and consent to the use by or the disclosureto any person or public body of any personal information that is collected under the authorityof the Planning Act for the purposes of this application.

Township of TinyMinor Variance ApplicationPage 7 of 7Consent of the Owner(s) forMunicipal Staff and Committee of Adjustment Membersto enter onto the subject lands for the purpose of inspecting the landsto evaluate the merits of the applicationI/We,, am/are the owner(s) of the land that is thesubject of this application for a minor variance and give permission to Municipal Staff and theCommittee of Adjustment Members to enter onto the subject land for the purpose ofinspecting the lands to evaluate the merits of the application.Date(Signature of Owner)(Signature of Owner)14. Sworn DeclarationI/We,of theofin theofsolemnly declare to the best of my knowledgethat the statements contained in this application are true and I make this solemndeclaration conscientiously believing it to be true and knowing that it is of the same forceand effect as if made under oath and by virtue of the Canada Evidence Act.(Signature of Owner/Agent)(Signature of Owner/Agent)TO BE COMPLETED BY COMMISSIONER OF OATHS OR NOTARY PUBLIC:Municipality Declaration Administered:Date of Declaration:Signature of Commissioner of Oathsor Notary Public:Commissioner of Oaths Stampor Notary Seal:Attachments:Appendix 1: Owner’s AuthorizationAppendix 2: Source Protection Plan Screening Form

130 Balm Beach Road WestTiny, Ontario L0L 2J0(705) 526-4204 1-866-939-8469www.tiny.caOWNER’S AUTHORIZATIONAppendix 1To be completed by the owner(s) if the person making application is not the owner(s).1. Agent AuthorizationsAuthorization of Owner(s) for AgentTo Make the ApplicationI/We,is the subject of this application and I/We authorizeto make this application on my/our behalf., am/are the owner(s) of the land thatAuthorization of Owner(s) for AgentTo Provide Personal InformationI/we,, am/are the owner(s) of the land thatis the subject of this application and for the purposes of the Freedom of Information andProtection of Privacy Act, I authorize, as my agentfor this application, to provide any of my personal information that will be included in thisapplication or collected during the processing of the application.Date:(Signature of Owner)(Signature of Owner)2. Cost Acknowledgement AgreementIn consideration of the Township of Tiny receiving this application;The Owner represents that he/she is/are the registered owner(s) of the lands described inthis application; andThe Owner recognizes that there may be a number of legal, planning, engineering, andenvironmental issues to be investigated and resolved which may necessitate time and efforton the part of both the Owner and the Township; andThe Township may find it necessary to engage professional services in consideration of theproposal; andThe Owner, in consideration of the associated professional services, hereby agrees asfollows:

Township of TinyOwner’s AuthorizationPage 2 of 21. In this agreement, “expenses” means all professional services and/or consultant’s feesand disbursements.2. The Township agrees to review the application and if necessary retain such additionallegal, planning, engineering, and environmental consultants as are necessary toproperly evaluate the application.3. The Owner shall submit with the application the required municipal administrationfee, which does not account for additional costs of associated professional services.4. The Owner agrees to be responsible for and agrees to reimburse the Township for allexpenses the Township may have incurred in respect of the application.5. As expenses are incurred by the Township, the Township shall pay the invoice(s) andsubmit an invoice to the Owner of the disbursements at which time the invoice(s) is tobe paid within 30 days.6. In the event that the invoice(s) remains outstanding for more than 30 days, theTownship may halt all work in respect of the application until all arrears are satisfied.7. The Owner may withdraw this application at any time, however, shall be responsiblefor the costs incurred up to the date that the Township of Tiny receives written noticeof withdrawal of the application.8. This Agreement shall not be construed as acceptance or approval by the Township ofthe application.(Signature of Owner)(Signature of Owner)3. Authorization for Site InspectionConsent of the Owner(s) forMunicipal Staff and Committee of Adjustment Membersto enter onto the subject lands for the purpose of inspecting the landsto evaluate the merits of the applicationI/We,, am/are the owner(s) of the land that is thesubject of this application and give permission to Municipal Staff and the Committee ofAdjustment Members to enter onto the subject land for the purpose of inspecting the lands toevaluate the merits of the application.Date:(Signature of Owner)(Signature of Owner)

SOURCE PROTECTION PLAN PRE-APPLICATION SCREENING FORMAppendix 2APPLICANT INFORMATIONName:Phone:E-mail:Fax:Mailing Address:Municipality:Prov:Postal Code:PROPERTY OWNER INFORMATION (IF DIFFERENT FROM ABOVE)Name:Phone:E-mail:Fax:Mailing Address:Town:Prov:Postal Code:PROPERTY INFORMATIONRoll Number:Legal Description:Lot:Conc.Lot:Plan:Street Address:Land ionalIndustrialVULNERABLE AREAS ASSESSMENTUsing the Vulnerable Areas Maps found on the Township of Tiny webpage at www.tiny.ca or at the Buildingand Planning front counter, identify the following information for the property(ies) in question.Vulnerable AreaZone:WHPA-AWHPA-BWHPA-C/C1WHPA-DVulnerability Score:APPLICATION FOR VARIANCE OR FOR PERMISSION

THE FOLLOWING SECTIONS REFER TO THE INFORMATION PROVIDED IN THE VULNERABILITY ASSESSMENT. PLEASEREFER TO THE SECTION HEADINGS FOR APPLICABLE SECTIONS TO BE FILLED IN.VULNERABILITY SCOREIf the subject property was found to be located within an area with a well head protection area please checkall proposed land uses or activities that apply to the subject property. For more information on the listedland uses or activities please contact the Severn Sound Environmental Association, the RiskManagement Office for the Township of Tiny, at 705-534-7283.Application of untreated septage to landWaste disposal siteMine TailingsStormwater management facilitiesWastewater treatment plants / sewer systemsOn-site sewage systemsIndustrial EffluentApplication of agricultural source materialsStorage of agricultural source materialsApplication of non-agricultural source materialHandling and storage of non-agricultural source materialsApplication of commercial fertilizerHandling and storage of commercial fertilizerApplication of pesticides to landHandling and storage of pesticidesApplication of road saltHandling and Storage of road saltStorage of snowHandling and storage of fuelHandling and storage of dense non-aqueous phase liquidHandling and storage of an organic solventManagement of run-off that contains chemicals used in the deicing of aircraftThe use of land as livestock grazing or pasturing land, an outdoor confinement area, or farm animal yardACKNOWLEDGEMENTI,, am the owner / authorized agent of the owner of the subject propertyas stated in this pre-screening application. I (the owner / authorized agent) certify that I have provided as muchinformation as possible and that all information submitted is to the best of my knowledge the truth.DateSignature of Owner / Authorized AgentPlease note that if any of the land uses or activities are checked above, confirmation that the proposeddevelopment is not a significant drinking water threat will be required from the Risk ManagementOffice.

Tiny, Ontario L0L 2J0 (705) 526-4204 1-866-939-8469. www.tiny.ca . APPLICATION FOR VARIANCE OR FOR PERMISSION. The following information and material is to be provided in an application under . Section 45 of the . Planning Act, R.S.O. 1990, c.P. 13 as amended: FOR OFFIC

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