Pre-Consultation Request

Required fields are marked with asterisks (*)

The purpose of a pre-consultation is to obtain a land use planning opinion in respect to a specific proposal prior to the submission of the formal application and the commencement of proceedings pursuant to the Planning Act. This request form was developed to assist Township Staff in understanding the proposal that is being considered. In all cases, a sketch is required that includes sufficient information, including any applicable dimensions, to explain the proposal. When deemed necessary by Township Staff, this pre-consultation could include outside agencies such as the Quinte Conservation Authority.

Owner Contact Information: List the names and contact information of the current registered owner(s)

Owner Name

Owner(s) Mailing Address

Owner's Phone Number

Owner's Email Address

Applicant Contact Information: If the person submitting this request is not identified as a current owner, please provide the name and contact information of the person submitting this request

Agent/ Applicant Name

Agent/Applicant Mailing Address

Agent/Applicant Phone Number

Agent/Applicant Email Address

The following information will help ensure that Township Staff are considering the proposal against the correct parcel of land

Civic Address of Subject Property

Assessment Roll Number

Legal Description of Property

Describe what the intended end result will be should your proposal eventually be approved

Include the names of any other outside agencies or other levels of government that you have pre-consulted with prior to the submission of this request.

Copy of any official responses should be included as part of this request

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Understanding of Application Terms
I am the owner of the land that is the subject of this application and for the purposes of the Freedom of Information and 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 purposes of processing this application.

Personal information contained in this form, collected and maintained pursuant to the Planning Act, will be used for the purpose of responding to the Application and creating a public record. The Owner’s Signature acknowledges that “personal information [is] collected and maintained specifically for the purpose of creating a record available to the general public;” per Section 14(1)(c) of the Municipal Freedom of Information and Protection of Privacy Act, R.S.O. 1990, c.M. 56.

By submitting this request, I agree to allow representatives of the Township of Stone Mills to enter the lands subject to this request for the purpose of conducting visual inspections and obtain any additional information, and further agree not to conduct any site alteration or remove any vegetation on the site during the review of this request.

I understand that I may have to pay application fees for any formal application. I understand that I may have to pay a fee to the Quinte Conservation Authority. I understand that I am responsible for all peer review and legal costs.

It is understood by the person submitting this request that any land use planning opinion arising from the submission of this request is not a guarantee that any subsequent application will be approved, and further that any ensuing application remains subject to the requirements of the Planning Act.

Authorization of Owner for Agent to make Application

I am the registered owner of the land that is subject of this requested meeting, and I authorize the agent/applicant to make this applicating on my behalf, and for the purpose of the pre-consultation process for these lands. The agent/applicant will provide my Personal information that will be included in this application or collected during the processing of the application.

Date of Request

Signature of Owner

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