COMMITTEE OF ADJUSTMENT APPLICATION FOR CHANGE OF CONDITIONS

• In addition to the submission requirements found on the application form, it is imperative that the applicant provide all the planning evidence necessary in support of the request being made. [...] AUTHORIZATION If this application is being made by an agent that is not the owner of the subject lands, written authorization of the owner is required, as below: I/we, , owner(s) of the land that is the subject of this application, hereby authorize to act on my/our behalf in regard to this application. [...] Submission of this application constitutes consent for authorized municipal staff to enter upon the subject property for the purpose of conducting site visits, including photographs, which are necessary for the evaluation of this application. [...] AFFIDAVIT (to be completed in person in the presence of a Commissioner of Oaths) I/we, , of the Town/City of , in the County/Regional Municipality of , solemnly declare that all of the above 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 vir. [...] Signature of Owner/Agent Signature of Owner/Agent Declared before me at the Town/City of in the County/Regional Municipality of this day of , 20 Signature of Commissioner of Oaths *Commissioner/Notary – please affix stamp *Lawyer – please print name beside signature SUBMISSION NUMBER: CC (to be assigned by staff) 1.