APPLICATION FOR RELIEF FROM PART LOT CONTROL - PART I – CONTACT INFORMATION

Name of Property Owner2 Phone Address Fax City, Postal Code E-mail When was the property acquired by the owner? 2 It is the responsibility of the owner or applicant to notify the Planning Department of any changes in ownership within 30 days of such a change. [...] Previous Use of Property Agricultural Commercial Industrial Institutional Residential Vacant Other(s) If Industrial or Commercial, specify use: If previous use of property is industrial or commercial or if YES to any of Section 5, a previous use inventory showing all former uses of the subject land, or if appropriate, the land adjacent to the subject land is required. [...] I acknowledge that the City of Brantford is not responsible for identification and remediation of contamination on the property, which is the subject of this Application – by reason of its approval to this Application. [...] Authorization If the applicant is not the owner of the land that is the subject of this application, the authorization set out below must be completed. [...] Authorization of Owner for Agent to make the Application I, am the owner of the land that is the subject of this application and I authorize to act as my agent in this matter and to make this application on my behalf and to provide any of my personal information that will be included in this application or collected during the processing of this application.