CITY OF KAWARTHA LAKES DEVELOPMENT SERVICES - PLANNING DIVISION

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					                               CITY OF KAWARTHA LAKES
                        DEVELOPMENT SERVICES - PLANNING DIVISION
                               CONSENT INQUIRY REPORT
                                   Fee Payable - $85.00
                                180 Kent Street West Lindsay, ON K9V 2Y6
                          Tel: 705-324-9411 Ext. 1231   Toll Free: 1-888-822-2225
OFFICE USE ONLY                                                              ID#_______________________
  Date Received: _____________________                                      Visa  MC    Cash Cheque
-This application must be submitted with Total Fee Payable                       Fee Receipt #____________

Owner’s Name                                                 Inquiry By:
_________________________________                            ___________________________________
Address__________________________                            Address___________________________

_________________________________                            __________________________________
Phone (          ) _____________________                     Phone (        ) ______________________
Fax       (     ) _____________________                      Fax       (   ) _______________________
Email: ___________________________                           Email: _____________________________



Street Name/# __________________________________________

Former Town/Township/Village ______________________________
Lot ______________                Conc. ____________
Lot(s) ________________________ Registered/Reference Plan _______________________
*Required entry*
Assessment Roll No.1651-____________________________ (refer to Tax bill or Municipal
Property Assessment Corporation (MPAC) Assessment Notice)

Known Previous Consent(s)              Y / N           If Yes, When ________________________ and

File Number(s)________________                      __________________           ______________________


       A New Lot             Addition to a Lot              Surplus Farm Dwelling (Must be an existing farm
                                                            dwelling that is surplus due to consolidation)
Proposed Use:


                                       Severed                                       Retained
                    Existing               Proposed                   Existing         Proposed
Frontage

Area
Nearest Barn

Use of Land


W:\CityKL\CityHall\Dept\DevServices\docs\Consent_Inquiry_Report_form.doc            May 2007
                               CITY OF KAWARTHA LAKES
                        DEVELOPMENT SERVICES - PLANNING DIVISION
                               CONSENT INQUIRY REPORT

          Please provide a clear sketch OR provide a copy of the boundary survey.
Include the Following Details:
•   Severed Land - Indicate Severed (S) lot by outlining it in Red
•   Retained Land - Indicate Retained (R) lot by outlining it in Green
•   Approx. location of all natural and artificial features (buildings, roads, wells, streams)
•   Boundary and dimensions of subject land




NOTE
•   M.D.S.
    Minimum Distance Separation is applicable in rural/agricultural areas and no residential lot
    may be created within the MDS radius. The maximum radius can be up to 1000 metres of
    any barns, feed lots and manure storage facilities.
•   Please note that if your property has potential for a severance, it does not guarantee that the
    application will be approved. All consent inquiries are based on current Provincial Policies
    and Provincial Plans and City policies and are subject to change.
•   Incomplete forms may take longer to process.
•   Upon receipt and response of this inquiry, you may then pursue a formal application for
    consent.




W:\CityKL\CityHall\Dept\DevServices\docs\Consent_Inquiry_Report_form.doc    May 2007

				
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