HomeMy WebLinkAboutP-70-80 CORPORATION OF THE TOWN OF NEWCASTLE
PLANNING AND DEVELOPMENT DEPARTMENT D.N.SMITH,M.C.I.P.,Director
HAMPTON,ONTARIO LOB 1JO TEL. (416)263-2231
REPORT TO THE PLANNING AND DEVELOPMENT COMMITTEE MEETING OF APRIL 14, 1980
REPORT NO.: P-70-80
a
SUBJECT: Consent Application LD 91/80
BACKGROUND:
On February 25, 1980, the Town received a request from the
Durham Land Division Committee for comments in respect of the above
noted severance application. The subject lands are located within
the proposed limits of the hamlet of Tyrone and are presently zoned
"R3" and "Cl" by the Darlington zoning by—law. We note that the
portion of the site zoned "Cl" contains an old school house which has
been converted to apartments. A portion of the building is apparently
being used as a business premises, which is necessary in order to
establish residential dwellings in a "Cl" zone.
Under the "R3" zone provisions for the balance of the site,
new lots must have a minimum lot area of 16,000 square feet with a
minimum frontage of 80 feet. The proposed severance would create a
lot having an area of 16,005 square feet and a frontage of 97 feet.
The retained portion would have an area of 27,555 square feet and a
frontage of 167 feet. In that regard, both the proposed and retained
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lots would appear to comply with the provisions of the Darlington
by-law. We note, however, that there are no minimum lot area require-
ments for residential uses within a "Cl" zone nor are there any mini-
mum lot area requirements for commercial uses within a "Cl" zone.
Staff note that on January 7, 1980, the Planning Committee
considered and adopted staff report P-5-80 which dealt with the revised
hamlet development plan for Tyrone. The plan stipulates a minimum lot
size of 1.25 acres (54,450 square feet) and if revised as proposed by
staff report P-54-80, this minimum could be reduced to 0.75 acres,
(32,670 square feet) based upon detailed on-site investigation. The
subject site presently has an area of 1.0 acres which is acceptable
for existing residential use. On January 14, 1980, Council referred
the hamlet plan back to the Planning Committee for further discussion.
At the Committee meeting of February 4, 1980, the staff report was again
considered and endorsed by resolution. This decision was ratified by
Council on February 11, 1980.
On March 3, 1980 a public meeting was held to discuss the revised
hamlet plan. On March 6, 1980, staff forwarded comments in respect of
the proposed severance to the Durham Land Division Committee, requesting
that the application be tabled pending Council's final approval of the
hamlet plan.
On March 17, 1980 the land division committee considered and
approved the applications. Staff note that in a similar situation in
Haydon, the applications were tabled as requested by the Town and does
not appear to be consistent with the decision made in this instance.
Formal notice of the approval was received on March 28, 1980 and we
note that the last date of appeal is April 17, 1980.
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On March 31, 1980 staff report P-54-80 was considered by
the Planning Committee and endorsed. Said report recommended that
the hamlet plan be forwarded to Regional Council, in accordance with
Section 10.4.2.2 of the Durham Official Plan, prior to local Council
adoption. This action was ratified by Council at its meeting of
April 8, 1980.
COMMENTS:
m
Staff are somewhat concerned with the approval of the subject
severance since it does not conform to the hamlet development plan as
it relates to lot size. Upon approval, the development plan will form the
basis for amendments to the Town's restricted area by-law in order to
provide a consistent set of policies and standards for the development
of this settlement area. In that regard, the issue of minimum lot size
has not yet been finalized. We note, however, that the proposed minimum
is intended to reduce potential problems related to the operation of in-
dividual wells and septic tanks and at the same time minimize impacts to
existing residences.
In accordance with direction provided by Council in respect of
two other decisions of the Land Division Committee, in Tyrone, staff
have forwarded an appeal of this decision to the Secretary of the Land
Division Committee. This was necessary in order to meet the deadline for
appeals and, if Council so chooses, after considering this report, the
appeal could be withdrawn. We are, therefore, seeking Council endorse-
ment of the staff action, or conversely, further direction in respect of
this matter.
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RECOMMENDATIONS:
That the Planning and Development Committee recommend to
Council the following:
1. That staff report P-70-80 be received; and that
2. The actions of staff in appealing the decision of
the Land Division Committee in respect of application
LD 91/80 be endorsed; and that
d
3. The Town solicitor and planning staff be authorized to
attend the hearing in respect of this matter and make
representation on behalf of the Town.
Respectfully submitted,
TTE:lb D. N. Smith, M.C.I.P.
April 9, 1980 Director of Planning
REGIONAL MUNICIPALITY OF DURHAM
LAND DIVISION COMMITTEE DECISION
As per the provisions of Sections 29 & 42 of The Planning Act as amended;
Section 61 (10) of The Regional Municipality of Durham Act as amended;
and Ontario Regulation 732/78 as amended
File LD 91/80 Submission B90/80 March 17th, 1980
Carol Byam & ,Doreen Park
Part Lot 9, Concession 6
Town of Newcastle
Mr. G. Byam accompanied by his brother-in-law Mr. Park was
present on behalf of this application. No further representation
was present in favour of or opposed to the application .
This application involves the severance of a 1487 m2 lot for
house.
residential use from a 4047 m2 lot containing an old school
Mr. Byam advised the Committee that he had attended the Public
Hearings on the Hamlet Development Plan for Tyrone and was
concerned that the lot sizes appear to change at each hearing and
do not conform to the present By-law requirements .
Members of the Committee, expressed the opinion that in the case
of the proposal it would constitute infilling within the existing
hamlet and would appear to be compatible with lots in the
immediate vicinity. To enlarge the subject land to accommodate a
proposal by the Town of Newcastle of one and a quarter acres
could possibly encroach on land presently used for agricultural
purposes to the rear. Notwithstanding the foregoing, an opinion
was expressed that as the plan appeared to be progressing that a
tabling motion would be appropriate.
The Committee had for their information reports received from the
Peterborough-Victoria-Northumberland and Newcastle Roman Catholic
Separate School Board, the Ministry of Natural Resources, the
Central Lake Ontario Conservation Authority, the Corporation of
the Town of Newcastle Planning & Development Department, the
Regional Works Department, the Regional Planning Department, the
Ministry of Agriculture and Food and the Durham Regional Health
Unit.
DECISION OF THE COMMITTEE
MOVED: W. Allin SECONDED: R. Bryson
THAT Application LD 91/80 be approved as applied for, as such is
an infilling situation within the limits of the Hamlet of Tyrone,
and in the opinion of the Committee is a unique situation in that
the only available land to be acquired to make the proposal fit
the proposed 1 and a quarter acre size contained in the Hamlet
Development Plan for Tyrone would remove land from agriculture ,
the proposal also conforms to the present by-law requirements ,
subject to:
1 . That the applicant satisfy the Town of Newcastle, financial
and otherwise.
Continued. . . . .
4/
REGIONAL MUNICIPALITY OF DURHAM
LAND DIVISION COMMITTEE DECISION (Continued)
File LD 91/80 (Continued) March 17th, 1980
Carol Byam & Doreen Park
Town of Newcastle
DECISION (Continued)
2. That the applicant satisfy all the requirements of the
Regional Municipality of Durham concerning the provision of
Regional services, financial and otherwise.
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3 . That the applicant submit two copies of a registered
reference plan for the clearance of documents.
4. That this approval shall lapse at the expiration of two years
from the date the decision is final and binding unless all
the conditions are fulfilled and the formal consent has been
released.
5 . That prior to the signing of the certificate given by the
Secretary/Treasurer that the consent has been given, the
Secretary/Treasurer is to be advised in writing by the Town
of Newcastle that Condition #1 has been carried out to their
satisfaction.
6 . That prior to the signing of the certificate given by the
Secretary/Treasurer that the consent has been given, the
Secretary/Treasurer is to be advised in writing by the
Regional Municipality of Durham Works Department that
Condition 42 has been carried out to their satisfaction.
CARRIED
March 17th, 1980
Wandless
-----------------L. Smith
Chairman Vice-Chairman
--R. MorrisonL"'`�"
-R. Rahmer
D. Jackson - -----R. Bryson
---
-----_------W. Allin ------------- -
---------=- -8obinson
S. Parker
Secretary/Treasurer
April 17th, 1980Last Date of Appeal
April 17th, 1982Expiry Date
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CORPORATION OF THE TOWN OF NEWCASTLE
PLANNING AND DEVELOPMENT DEPARTMENT D.N.SMITH,M.C.I.P., Director
HAMPTON,ONTARIO LOB 1JO TEL. (416)263-2231
COMMENTS TO LAND DIVISION COMMITTEE ON CONSENT APPLICATIONS FOR THE
MEETING OF MARCH 17, 1980.
Application No. : LD 91/80
Applicant: C. Byam and D. Park
Location: Part Lot 9, Concession 6, former Township of
Darlington
Proposed Use: Residential
CONFORMITY WITH OFFICIAL PLAN:
t The site is designated "Hamlet" in the Region of Durham Official
Plan. Section 10.4.1.4 of the Plan would permit residential develop-
ment within Hamlets in the form of infilling to existing development.
The site is designated "Residential" in the Darlington Official Plan.
Section 3(7A) (g) of the Plan encourages non-agricultural development
to locate as infilling in, or adjacent to, existing Hamlets.
CONFORMITY WITH ZONING BY-LAWS:
Yes. Both the "subject" and "retained" land comply with the applicable
provisions of the 'R3' Residential zone in the Darlington Zoning By-law.
OTHER COMMENTS:
The Town of Newcastle Planning staff have prepared a Hamlet Development
Plan for Tyrone in accordance with the provisions of the Durham Regional
Official Plan. This Development Plan, which has been forwarded to the
Town's Planning Committee for approval, in accordance with Section 10.4.2.2
of the Durham Plan, would permit the severance of one lot, having a min-
imum area of 0.5 ha (1.25 acres) in this location. Inasmuch as the pro-
posal would effectively sever a lot with an area of approximately 0.1 ha
(. 36 acres) , it is our opinion that approval of this proposal would under-
mine the intent of the Hamlet Development Plan, which has been subjected
to extensive review and public discussion through the planning process.
, m
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RECOIZ ENDATIONS:
We recommend that the subject application be tabled, pending the
approval of the Hamlet Plan by Council. However, if the Land Div-
ision Committee sees fit to approve the subject application then a
lot development charge of $1500 shall apply.
EP:lb Norma J. Forrest
March 6, 1980 Current Operations Planner
F
NOTICE OF HEARING
TL
AND
REQUEST FOR COMMENTS
DURHAM February 20, 1980
The Regional
Municipality
of Durham
Planning
DsperUnent
Box 6z
106 Consumers Dr.
Whitby, Ontario
Canada,LIN 6A3
14161 668-7731
Re: LD 91/80
Dame C. Byam & D. Park
DR. M. R. MICHAEL, M.C.I.P, Location Part Lot 91 Conc. 6
Comrnisasotusr of Planning
Town of Newcastle
The application for consent is scheduled for
hearing by the Durham Land Division Committee in
the Council Chambers, Regional Headquarters Building,
605 Rossland Road East, Whitby, Ontario.
March 17, 1980
at 1: 00 P.M.
Representation may be made at the hearing, if so
desired either in person or by writing.
Attached please find application form and sketch
to this application. Comments are respectfullv
requested for the Committee ' s consideration. In
order to facilitate processing of the application,
comments should be returned by March 10 , 1980
Please note that this application has been
ci ulated for comments to the agencies marked
( on page 2 .
Yours truly,
S . Parker (Mrs. )
Secretary/Treasurer
CIRCULATION LIST
Regional Municipality of Durham
_✓Regional Clerk
ddepartment of Planning
epartment of Works
_Department of Development
Town of Newcastle
_✓Clerk
_✓Planner
1,16hairman, Planning Advisory Committee
Other Agencies
Ventral Lake Ontario Conservation Authority
G�naraska Conservation Authority
]; iniD ham Regional Health Unit
M of Natural Resources - Lindsay
strY Durham Board of Education
—Durham Separate School Board
,/Northumberland Board of Education
,,-Northumberland Separate School Board
Ministry of Housing
Ministry of Agriculture & Food
M*nistry of Transportation & Communications
✓File
Attachment: Application Form & Sketch
L 7-�i
REGIONAL ; G✓
, �, r •� O"ICE OF THE
tiIUNICIPALITY /( IAhO o,�,nohCO�bnrEe
�'� 7 ,ry COhzVa.Eai pa rvE
-"I TOY• Ohdw 6,0, Uh �wJ
OF
��,_ c� rHOrvE ,•.sataoo•ni�
DURNAPvl
APPLICATION FOR CONSENT
DURHAM as per The Planning Act Sections 29 &42 R S C' 1970
Bill 162 Section 51(10) and In :ctardancr with the
Provincial Rules of Procedu•e FCC ,..
PL.=ASE TYPE OR USE BLACK INK FOR REPRODUCTION PURPOSES,
IN METRIC. AND ALL 11EASUREME2STS MUST BE GIVEN
The Secretary-Treasurer will not accept the application until all e required information
has been provided. the
NOT_°. 11: This application, together with all supporting documents, must be filed in duplicate
unless otherwise npted, with the Secretary-Treasurer of the Durham Land Division
Committee, and must be accompanied by a fee of $50.00 in cash or by cheque made payable
to the Treasurer of the Regional Municipality of Durham. It is policy of the Durham
Land Division Committee that each additional lot to be separated by an applicant is to
be considered as a separate application and subject to an additional 550.00 application
fee.
NOTE #2: This application is not considered complete until all requirements have been met in full.
1 i #3: Unless otherwise requested, all communications will be sent to the agent, if any. The
undersigned hereby applies to the Durham Land Division Committee under Sections 29 and 30
of the Planning Act, R.S.O. 1970, Chapter 349, as amended, for consent to the transaction
as described, and to the extent set forth in this application..
•1. Name of Applicant ,C:31':;� „�o I3Vm -Uc�ree P r?t <
Address .... i O..t�..°. C.7.�..EO.d13AG�i�@�..�? p Tel. No.
2. Name of Owner (if other than applicant) ....?a?le....R................ ........ e... ...
Address .............
3- Name of Agent (if any) Gren'liil e--5y ....... ................ .... ............. . .
.. ......... ..... Tel. No. ..z53-2b50
Address -- -
4. Nam® of person (s) (purchaser, lessee, mortgagee, etc.) to Y#c= land or interest in
land is intended to be conveyed, leased or mortgaged: .,, ,,4�r' X11
Address ...... ..... ......... .......... ... .. ...... ... .. . ..
Relationship to Owner (if any) ... ...... ......... ... . .... ....... .. .... ......... ..... .
S. Please specify to whom all communications should be sent:•.. •. --•.••. .- •-. - . -
Owner ( ) ( �� )
Agent Solicitor ( )
6. Tope of transaction for which application for consent is being sade_appropriate space or spaces) :
(Insert "Y=S" in
(a) Conveyance ,'e S
(i) creation of new lot . .........Y v......... ..... .. . . .... ... .... . ... .... .. . . .
.... .... . ..... . .. .. ... . . .
(ii) technical severance (i.e., the land being severed and the land being
retained were formerly separate holdings but have since become
consolidated) ., , ,-,,,•••••_ --
(iii)addition to a lot ......... ......... ...... . .. ... .......... ... .. . .. . . .. .. . . .
(iv) creation of lot(s) for se_.ai-detached or row-housing-... ,,,,,_„. . ... ... . ... ..
(b)Mortgage or Charge ........ . .. .>.. .. . ....... . .. .. . . . . ...
(c)Partial Discharge of Mortgage .•.••......• .• . .• . . ... .. .. ....
(i) easement/right of way . . ... .. .. .. ............ ... .. .... .... ... .. .. .. .... . . .
agreement of sale and purchase _ • -•
(iii)correction of title .... .. . . .. . .. . .. . ... .. .. . .
(iv) other (specify) ....... . . . ...... . .. . .. ... ... . . .. . .. . . .. .. .. .. . . . . . . .. . . . .
Description of land for which application for consent.is being (hereinafter
referred to as 'Subject Land') : _ -
(m) Yeaal Description iMcY.icipality, former nun4cipality, of k
on (( , Concession, or Plan) :
.e.. C...C.°. .t.y..`..r-. .. . ".. Y1 .... . _
(b) Municipal Address (Street and `tuab a .
e=, _ any)
Tyronea OnLari,.
°- Total .n::ner o_° lots . . . . . .. . .. . .. . .. .. .. . . .. . . . .. .. . . . . . . ... . .. ..
(i,cludinq retained lots) ••Lich are the subject of =iis
applica-_�.. . . . . . . . . . . . . . . . . . .^.. . .. . . . . .. . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
�SFp;'1iy.1
2
9. Dimension of Land:
Subject Land
(a) Frontage: Retained
Land
(b) Average Width: . . —5.
(c) Average Depth: .... . .
(d)
. . ..5.Q 2.,II..
(e) Existing Structures. ..... .Z56 ....
10. (I) Use of ----.Y !q tr..... - '� `'Am..�.. .
land to be severed: ��A
.... . hOLI
Exist��
t
Urban Residential PrO- D-seed
Farm Related Rural
Residential
-Farm Related Vacant . . ..... ..... ..
Rural Residential side—yards to
; 13 _use
Seasonal Residential .... . ..Yom.. ..... . ..
Mobile Home Park ...... .. .. ............
Commercial
Tourist Recreational .•.. ..•... .. . ... ..
�1 Agricultural .. .. ......... .... .. .....
Institutional ................... . ...... .. .
Industrial ....... .......... .....
Parkland ....-•... ... .. .... ... .
Bushland ...... ............ ....
Utility ... ... ..
Other (specify) ... .................
(2) - Elaborate with particulars of any item....... - ... .. ......... ... .. . ...
..... •• .............................. (s) designated above:
- •
(3) Number and type of•built.................. .........•... . .. .. .. .. ... ...
to be severed. dings and structures (both existin a •• • .
Vacant g and proposed) •on
I1. the land
(1) Use of land to be retained;
Ex1
s ti_Q
Urban Residential Pr see
Farm Related Rural .. ..... ..
Residential "
Non-Farm Related _
Rural Residential
Seasonal Residential .... ....... ... ... .. .. .
Mobile Home Park .............. ..... ...
Commercial -.....Yes..... ........ .. .. .. ... ......
....................... . '
Tourist Recreational ......... . e-S .. ... ... . .. ..
Agricultural .. ......... ...... ...... . ....•...... ... .. . .... .
Institutional ... .. ......... .. . .. . ..
Industrial -• . .. .... ... . ..
Parkland
Bushland
Other (specify) . .. ... . .... .. .. . . . . ..
(2) Elaborate with particulars of -an .. .. . es . gnat ... bove .. .. .... .. ..... . .. .. .. ..
y item(s) des�g ate
ha bee n above.
4v. . .. . .. . . ?.�'; =f�I'tedtu 4 apaxx-ax ments jitt:
in the base.nent
(3) Number and type of existin . . . . . ... . .. . .. . ... .. .... .. .. .... 0. .. .. .
• • • •• -�. .b ri ��C:;:.Q� b� lcincs and structures on t e land to be retained.
ck. 4�.u, . . .. . .. .. . . ..... . . . . . .. .. . ... . . . . . . ...
3
12. Is the severed lot to be conveyed to a family member?
Yes ..... No ...4.
If yes, relationship ... .. ......... ... ... ...... .
13. Is the retained lot to be used for retirement purposes?
Yes ..... No ..�..
14. Is the purpose of the severance to dispose of a surplus duelling?
Yes ..... No ....i,
15. Has the grantor previously conveyed any land from his holdings?
Yes ... .. No (If yes, please indicate on the required sketch.)
How many separate parcels have been created? ( ) For what use?
.......... ...........
Has the parcel to be severed ever been or is it part of an application for a plan of
subdivision under the terms of Section 33 of The Planning Act?
.JO
..................... . ............. ........•............ .. .
Has the grantor applied for a variance or zoning amendment ap lication in connection
with this application? Please give date: ............ . .....1NA.......... ... .......... .. . .
16.-.Zoning Regulations: Subject Land Retained Land
(a) By-law Number:
(b) Zoning Category: ... ..... ....2J,a1. ras..Ar*iended
(c) Minimum Frontage: ... in ....21, 3i.4.t4
(d) Minimum Area ID ...6,:J'_E?. aq..;n
Please contact your local Municipality for information on Question 16..
17, Water Supply:
(a) Is a municipally owned and operated piped water supply available to:
(1) Subject Land? Yes ( ) No ( X )
(ii)Land to be retained? Yes ( ) No ( :C )
(b) If "NO", what other water supply is proposed? Drilled well
IS. -Sewage Disposal:
(a) Are municipally owned and operated sanitary sewers available to:
(i) Subject Land? Yes ( ) No ` :{
(ii)Land to be retained? Yes ( ) No
K
(b) If "NO", what other system of disposal of sanitary sewage is proposed? Individual
19. Access: Septic tank
_ (a) The subject land is accessible by:
Name of road or street ...........�U�'.p17:1.ZA8�.1�jUbAt'i6�.��............
Is it a public travelled road or street? .... ..YP_3..................... ..
(Municipal, Regional, Highway or County Road)
Is it an unopened road allowance? ........ 74O
......... ....... .. ........
Is it a private road or street? ..................... t'JO_.. . . ,. .w.... .
(b) If there is not access by road or street, what means of access is proposed? ��/
(c) If access is by water, what boat docking and parking facilities are available
on the mainland? N/A
20. Characteristics of the subject land: (Indicate "Yes" or "No" in each space and add
explanatory comment where appropriate) .
(a) Is the land subject to flooding from a river, lake or other watercourse or body
of water? Yes ( ) No
Explanatory comment if any: ... ...... .... .. .......... . . .. .... .. .. .
(b) Is the land subject to seasonal wetness? Yes ( ) No
Explanatory comment, if anv: . ........ .. ... ....... ... .. . ....... . . ... ...... ... ... .. . . .
(c) Is the ground water level less than 1.3 meters from the surface of any part of
the land -at any time of the year? Yes ( ) No ( .. )
If "Yes", give details: ...... .. ... ... .... .. ... .... ... .. ......... ... .... .. ... ... . . . .
u �
4 -
(d) Is any part of the land swampy? Yes ( ) No ( )
(R If "Yes", give details: .... ....... .... ...... .... .. .......... .. ... ..... ... ....... .... ...
(e) Is there visual evidence of erosion from water or wind action on any part of the
land? Yes ( } No ( ;C )
If "Yes", give details: .... ............. .... ... .............. .. ................... ...
21. Where municipally owned and operated sanitary sewerage is not available, give the
nature and Dorositv of the soil: (Indicate the type of soil: clay, gravel, sand,
rock, etc. , and porosity and drainage characteristics of the soil) .
Bond Head Loam — Blood draina-e and porosity�
W Where municipally owned piped water supp�y and sanitary sewerage is not available,
give the depth of the soil. Unknown
(ii) Does bedrock come within 3.05 meters of the surface of any part of the land?
Yes ( ) No ( X )
If "Yes", give details: ...... .................................................•--•- .. ..
22. IMPORTANT - - - PLAN REQUIRED
The applicant shall submit with this application three (2) copies of a plan. If
the sketch required to be submitted with the applicatior. is larger than 21.5 cm x 35.5 cm
(W x 14") a total of twenty-five (25) copies are to be submitted with the application.
The required plan must show the following information:
(a) The boundaries, with all dimensions and the area of the owner's land or land in
which the owner has an interest abutting the land that is intended to be severed;
the distance from these boundaries to the Township lot lines and the distance
from these boundaries to the nearest road junctions (bridges, railway crossings
or other land marks) .
(b) The boundaries, with all dimensions and the area of the land that is intended
to be severed, showing its exact location and the distance from these boundaries
to the boundaries of the owner's land or land in which the owner has an interest.
(c) The boundaries of all lands previously conveyed by the owner from his original holdings.
(d) The location of all natural and artificial features including buildings, railways,
pipelines, highways, watercourses, drainage ditches, banks, slopes of land, swamps ,
wooded areas, wells and septic tile fields on both the lands intended to be.severed
and the lands intended to be retained and any similar features on adjacent lands.
(e) The nature of the existing uses of adjacent lands, e.g. farm residence, non-farm
residence, agriculture, summer cottage, service station, store, factory, etc.
(f) The location, widths, and names of all streets, roads or highways within or adjacent
to the lands intended to be severed and the lands intended to be retained indicating
whether they are public travelled roads, private roads or right-of-ways.
(g) The location and nature of any restrictive covenant or easement affecting the lands
intended to be severed or the lands intended to be retained.
When required by the Committee, the plan mentioned in Subsection 1 shall be signed by an
Ontario Land Surveyor, but otherwise a hand-drawn sketch to scale will be acceptable.
I .......Qmlyi .l ' .5ya,71 ...... of . °.ZQ�d:1. tLe....... of the Region of
solemnly declare that:
all above statements and the statements contained in all of the exhibits
transmitted herewith 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
,7
made under oath. �L
DECLARED befo e�m�e at the .... .. ..... .......... .. .... ...)
of .. ..:Y.:! �.................. in the Region of) .::::... ._:."....:. .... .... .
• f Signature of Owner, Applicant or
.. .... .. ....` :.... this ...........................) Authorized Agent
day of ........ abruaz-,r ....... ..... 19 ....It .........A.D.)
�
... ... f�
•A•Commissioner, Etc. -� - - -,
NOTE: IF THIS APPLICATION IS SIGNED BY AN APPLICANT OTHER THAN THE OWNER, OR BY AN
AGENT, WRITTEN AUTHORIZATION OF THE OWNER MUST ACCOMPANY THE APPLICATION.
IF THE APPLICANT IS A CORPORATION, THE APPLICATION SHALL BE SIGNED BY AN
OFFICER OF TF.E .CORPORATION AND THE CORPORATION'S SEAL SHALL BE AFFIXED.
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