COMMITTEE OF ADJUSTMENT - SUBMISSION CHECKLIST

No Yes _____________________________________________________________________ Has any land been severed from the parcel originally acquired by the owner of the subject land? If Yes, provide for each parcel severed, the date of transfer, the name of the transferee and the land use. [...] No Yes _____________________________________________________________________ Is the subject land the subject of an application for a zoning by-law amendment, Minister’s zoning order amendment, minor variance or approval of a plan of subdivision? If Yes, and if known, specify the appropriate file number and status of application. [...] ▪ The boundaries and dimensions of any land owned by the owner of the subject land and that abuts the subject land. [...] 8.0 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 consent application and for the purpose of the Freedom of 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 th. [...] __________________________________________ Print Name __________________________________________ ________________________________ Signature (Owner or Agent) Date 9.0 AUTHORIZATION OF USING AN AGENT BY OWNER: I, ___________________________________________________ am the owner of the land that is the subject of this application for a consent and for the purposes of the Freedom of Information and Pro.