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Pre-Consultation Meeting Request Form

Township of West Lincoln Planning and Building Department

Updated: May 2023

Please fill out the following to arrange a pre-consultation meeting with Township Staff. Pre-consultation meetings are generally held on the first and third Thursdays of every month, on a first come, first serve basis and are held at the Township Municipal Office, 318 Canborough Street Smithville, ON, L0R 2A0.

Once filled and returned, Township staff will schedule the meeting date and circulate to the Niagara Peninsula Conservation Authority, Region of Niagara, Building Department and Public Works Departments, as well as other applicable agencies. Pre-Consultation meetings are required prior to submission of the following Planning Applications: Severance, Subdivision, Condominium, Site Plan and Zoning By-law Amendments.

The Township of West Lincoln requires a fee of $310.00 for scheduling a pre-consultation meeting. This fee can be used towards a planning application fee related to the pre-consultation meeting within 1 year of the pre-consultation meeting.

In additon, the Region of Niagara has advised the Township that they will now (as of April 1st, 2023) require a $500 non-refundable/non-reductionable fee from applicants wishing to have a pre-consultation meeting scheduled. This fee is not applicable in regards to Minor Variance or Consent applications. This fee can be submitted to the Township by cheque, made paybale to the "Region of Niagara" and staff will forward the payment onto the Region of Niagara.

Please submit this completed form and any required attachments to:

Gerrit Boerema, Senior Planner

gboerema@westlincoln.ca

Telephone: (905) 957-5133

1.(a) Subject Property Information - Street Address:

Unit No.:

Lot/Con:

Municipality:

Postal Code:

Plan Number:

Roll Number:

Land Area:

1.(b) Applicant - Applicant is:

Owner

Authorized Agent of Owner

Last Name:

First Name:

Corporation or Partnership:

Street Address:

Unit No.:

Lot/Con:

Municipality:

Postal Code:

Province:

Telephone Number:

Cell Number:

Email:

1.(c) Owner (if different from applicant)

Last Name:

First Name:

Corporation or Partnership:

Street Address:

Unit No.:

Lot/Con:

Municipality:

Postal Code:

Province:

Telephone Number:

Cell Number:

Email:

2. Please name those who will be attending the pre-consultation meeting.

3. Description of Proposal:

4. Please attach a draft sketch of the proposal when submitting this form.

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

5. Property Information

Does the property abut a ravine, watercourse, wetland or shoreline?

Yes

Has the property been used or is being used as an industrial or commercial property?

Yes

Is the property a former waste disposal site?

Yes

Are there any potential contamination issues on the subject lands?

Yes

Is the proposed building or development near a livestock barn or manure storage facility?

Yes

Is there a natural gas well or other petroleum resource operation on the subject property? (Please show any wells on sketch)

Yes

If yes, is the gas well(s) being actively used for resource extraction?

Yes

Are there any gas wells in within 75 metres of the proposed development? (e.g. building location, proposed lot line, parking lot, etc.)

Yes

Are there any water wells on the subject property? (Please show location of any wells on sketch)

Yes

If yes, is the well being actively used?

Yes

6. Declaration of Applicant

ceritfy that the information provided on this document is true to the best of my knowledge and that this information can be shared with various agencies and departments as part of the planning review process.

Date:

Signature:

Clear

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Pre-Consultation Meeting Request Form