Community of Miltonvale Park
Tel.
(902) 368-3090 Address: Community of Miltonvale Park
Fax (902) 368-1152 PO Box 38, Winsloe PE
E-mail: develop@miltonvalepark.com C1E 1Z2
Website: www.miltonvalepark.com Canada
APPLICATION FOR DEVELOPMENT
APPROVAL
INSTRUCTIONS: Check
Area(s) applied for:
( ) Construct New Building (
) Addition ( ) Mobile Home ( )
Mini-home ( ) Change the Use of Building ( ) Change the Location of Building /
Structure on Property ( )
Move a Building / Structure to
Property__________________________________________________________________
1. Property Information: Property Owners Name: ....................................................................... Property Tax No. ................... Subdivision Lot No. (if applicable) ............................................
Civic Address Number ( ) yes ( ) no If yes, please provide no. ......................................
If property has frontage on private or public road, please provide name ...........................
Size of property being developed : Road Frontage Width ................... Depth .................... Existing land use of the property ........................................................... Area .
2. Applicant Information: Applicants Name: ..............................................................................
Mailing Address: ................................................................................... Postal Code:.................
(h) phone . ..................... (w) phone . .............. Fax .............. E-mail ........................................
3. Highway Access Information: Will the development require the creation of a new highway access driveway or the relocation of an existing access driveway? ( )Yes ( ) No
4. Development/Building Permit
Information:
If existing, what is the present use of the building..
.n/a ( )
The proposed use of the new (
) or existing ( )
structure is:
Residential: ( ) single
family ( ) duplex
( ) multiple ( )
mini home ( ) mobile home
( ) summer cottage ( )
rental cottage ( ) agriculture ( )
commercial ( ) industrial
( ) institutional ( )
non-commercial garage ( ) non-commercial storage building
( ) storage building ( )
travel trailer ( ) other, please describe
.
If an addition, what is the purpose
n/a ( )
5. Size of Building, Structure
or Addition: No.of Stories/ height ..
. No. of Bedrooms
...
Main Building: (if applicable) Addition: (if
applicable)
1st Floor
ft. x
ft.=
sq.ft 1st Floor
ft. x
ft.=
sq.ft
2nd Floor
ft. x
ft.=
sq.ft 2nd
Floor
ft. x
ft.=
sq.ft
Accessory Building: (if applicable) Structure: (if applicable)
ft. x
ft. =
sq.ft
ft.
x
ft. =
sq.ft
Total square footage of construction for main
building and/or addition
sq. ft.
Total square footage of all structures/buildings proposed for the site
...sq. ft.
Type of foundation
.
exterior wall finish
.. Roof material
.
5. Location of building, structure or addition:
(a) Distance to the center line of the nearest road, street or right-of-way? ft. (b) Distance to the nearest property boundary? ft.
(c) Distance to the nearest watercourse, wetland or salt water body on property? .
(d) If an addition, or moving a building or structure on site, will the proposed addition or
building cover an existing well ? Yes ( ) No ( )
(e) If an addition or moving building or structure on site, will any portion of the addition or building be less than 20 feet from the sewage disposal system ? Yes ( ) No ( ) If Yes, describe the details ..........................................................................................................
6. Mobile Home Application Only:
Factory built: Yes ( ) No ( ) Model name:................................. Age of home: ..............
Size of home: Length ...............ft Width ..................ft No. of bedrooms .....................
7. Type of Servicing:
(a) Do you plan to construct or upgrade a sewage disposal system? ( ) Yes ( ) No
If No, please explain ................................................................................................................. (b) Do you plan to construct an on-site well? ( ) Yes ( ) No
If No, please explain ........................................ .........................................................................
(c) Will there be underground fuel storage? (Other than oil tank in basement) ( )Yes ( )No 8. Estimated Cost of the Project: ..........................................
(a) When do you plan to start ......................... and finish construction ? ................................
9. Complete the attached
Development Application Sketch.
I HEREBY CERTIFY THAT TO THE
BEST OF MY KNOWLEDGE AND ABILITY, THE INFORMATION THAT I HAVE PROVIDED ON THIS
FORM IS TRUE AND COMPLETE.
_____________________________________________
_____________________________
Signature Date
The application along with the application fee should be forwarded to the above address. For further information and/or assistance, please drop into the community office (Winsloe Lions Hall) on Monday mornings (April-Mid-November) or phone the community office at 368-3090.
Municipality Use Only :
Development Permit No. ............. Date Application Received ................................ Fees Paid .................
Development Application Sketch
Name________________________
Note: This sketch is required as part of the Development Application. The information below must be checked, where applicable, as shown to scale in the sketch space provided.
( ) show property boundaries and dimensions (
) show roads
( ) all structures including exterior
dimensions ( ) setbacks from side and rear property lines
( ) distance of structures from centre of
roads ( ) distance from watercourse, top of bank
( ) distance of center of driveway to property
line ( ) natural slope of land
( )
show location of well and septic system and distance from structures,
property lines and separation
distance between well and septic system

Non-identifying
information contained on this form will be posted on the PEI Property Planning
Website and in the community, as per provincial regulations.