Forty Mile Sub Application 2013 V2

DATE of receipt of Application*

Date

Fee Submitted

FILE NO.

THIS FORM is TO BE COMPLETED IN FULL WHEREVER APPLICABLE BY THE REGISTERED OWNER OF THE LAND THAT IS THE SUBJECT OF

THE APPLICATION OR BY A PERSON AUTHORIZED TO ACT ON THE REGISTERED OWNER'S BEHALF

1. Name of registered owner of land to be subdivided*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Telephone*

2. Name of agent, if any.

(Person authorized to act on behalf of registered owner)

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Telephone

3. LEGAL DESCRIPTION AND AREA OF LAND TO BE SUBDIVIDED

All/part of the blanks 1/4 sec. blank Twp blank Range blank West of blank Meridan

Being all/part of lot(s)

block(s)

Reg. Plan No.

C.O.T. No.

Area of the above parcel of land to be subdivided blanks hectares

Municipal address (if applicable)

4. LOCATION OF LAND TO BE SUBDIVIDED

a. The land is situated in the Municipality of

b. Is the land situated immediately adjacent to the municipal boundary?

YesNo

If "yes", the adjoining municipality is*

c. Is the land situated within 0.8 kilometres of the right of way of a highway?

YesNo

If "yes", the highway in No.*

d. Does the proposed parcel contain or is it bounded by a river, stream, lake or other body of water or by a drainage ditch

YesNo

If "yes", state its name*

e. Is the proposed parcel within 1.5 km. of a sour gas facility?

YesNo

5. EXISTING AND PROPOSED USE OF LAND TO BE SUBDIVIDED

a. Existing use of the land

b. Proposed use of the land,

c. The designated use of the land as classified under a land use bylaw

6. PHYSICAL CHARACTERISTICS OF LAND TO BE SUBDIVIDED (WHERE APPROPRIATE)

a. Describe the nature of the top topography of the land (flat, rolling, steep, mixed)

b. Describe the nature of the vegetation and water on the land (brush, shrubs, tree stands, woodlot, etc. sloughs, creeks, etc.)

c. Describe the kind of soil on the land (sandy, loam, clay, etc)

7. EXISTING BUILDINGS ON THE LAND TO BE SUBDIVIDED

a. Describe any building and any structures on the land and whether they are to be demolished or removed

8. WATER AND SEWER SERVICES

If the proposed subdivision is to be served by other than a water distribution system and a wastewater collection system, describe the manner of providing water and sewage disposal

9. REGISTERED OWNER OR PERSON ACTING ON THE REGISTERED OWNER'S BEHALF

I, First & last name* hereby certify that blank* I am the registered owner, or
*I am the agent authorized to act on behalf of the registered owner and that the information given on this form is full and complete and is, to the best of my knowledge, a true statement of the facts relating to this application for subdivision.

Address*

(Signed)*

Telephone No*

Date*

Date

10. FURTHER RELEVANT INFORMATION

a. Number of Parcels being created blanks

b. Size of parcels being created blanks Hectares

c. Disposition of Reserve:
(i) Deferral (ii) Deferral of balance or (iii) Money-in-place

11. REASONS FOR SUBDIVISION, and any other relevant information in support of the application

NOTE: There is no obligation upon the Subdivision Approving Authority to return to the applicant either a subdivision application or documentation accompanying it.

12. RIGHT OF ENTRY

I hereby authorize the subdivision authority to enter my land for purpose of conducting a site inspection in connection with my application for subdivision approval should staff consider it necessary. This right is granted pursuant to the Municipal Government Act Revised Statutes of Alberta 2000.

Owners Signature*

13. SUBDIVISION FEES AND CONTACT INFO:

Subdivision fees for the County of Forty Mile No. 8 are $400.00 plus $100.00 per lot proposed to be created (no GST Payable), excluding parcels proposed as reserve or public utility parcels. After approval, a fee of $100.00 (no GST Payable) per endorsement of each subdivision instrument is required.
For a title separation of existing lots registered before 1950, a fee of $300.00 (includes endorsement fee) is required.
Applications should be submitted to:

Planning Advisor

County of Forty Mile No. 8

PO Box 160, Foremost, Alberta TOK 0X0

PH: PH (403)867-3530 FAX (403)867-2242

E-mail: planning@fortymile.ab.ca

THIS SECTION FOR OFFICIAL USE

SCHEDULE 1 FORM 1 APPLICATION FOR SUBDIVISION