Last Name:

First Name:

Company Name or Association Name (Association must be incorporated – include copy of letter of incorporation):

Email Address:

Daytime Telephone Number: ext.

Alternative Telephone Number:

Mailing Address:

Unit Number: Street Number:

Street Name:

P.O. Box:

City/Town:

Province:

Country: Postal Code:

I hereby authorize the named company and/or individual(s) to represent me

Last Name:

First Name:

Company Name or Association Name (Association must be incorporated – include copy of letter of incorporation):

Email Address(es):

Daytime Telephone Number: ext.

Alternative Telephone Number:

Mailing Address:

Unit Number: Street Number:

Street Name:

P.O. Box:

City/Town:

Province:

Country: Postal Code:

Note: If your representative is not licensed under the Law Society Act, please confirm that they have your written authorization, as required by the OLT Rules of Practice and Procedure, to act on your behalf and that they are also exempt under the Law Society’s by-laws to provide legal services. Please confirm this by checking the box below.

I certify that I understand that my representative is not licensed under the Law Society Act and I have provided my written authorization to my representative to act on my behalf with respect to this matter. I understand that my representative may be asked to produce this authorization at any time along with confirmation of their exemption under the Law Society’s by-laws to provide legal services.

Are you the current owner of the subject property?

Yes No

Address and/or Legal Description of property subject to the appeal:

Municipality:

Upper Tier (Example: county, district, region):

Do you require services in French?

Yes No

Number of new residential units proposed:

Municipal Reference Number(s):

List the reasons for your appeal:

Has a public meeting been held by the municipality? Yes No

For appeals of Official Plans, Official Plan Amendments, Zoning By-laws and Zoning By-law Amendments, please indicate if you will rely on one or more of the following grounds:

A: A decision of a Council or Approval Authority is:

Inconsistent with the Provincial Policy Statement issued under subsection 3(1) of the Planning Act

Fails to conform with or conflicts with a provincial plan

Fails to conform with an applicable Official Plan

And
B: For a non-decision or decision to refuse by council:

Consistency with the provincial policy statement, issued under subsection 3(1) of the Planning Act

Conformity with a provincial plan

Conformity with the upper-tier municipality’s Official Plan or an applicable Official Plan

If it is your intention to argue one or more of the above grounds, please explain your reasons:

Did you make your opinions regarding this matter known to council?

Oral submissions at a public meeting of council

Written submissions to council

Not applicable

Are there other appeals not yet filed with the Municipality? Yes No

Are there other matters related to this appeal? (For example: A consent application connected to a variance application). Yes No

If yes, please provide the Ontario Land Tribunal Case Number(s) and/or Municipal File Number(s) for the related matters:

Date application submitted to municipality if known (yyyy/mm/dd):

Date municipality deemed the application complete if known (yyyy/mm/dd):

Please briefly explain the proposal and describe the lands under appeal:

There are required documents and materials to be submitted to the Ontario Land Tribunal (OLT) based on the type of legislation and section you are filing under. Please see the Section 3B Checklist(s) located here and submit all documents listed.

Outline the grounds for the appeal and the relief requested:

Reference Number of the decision under appeal:

Portions of the decision in dispute:

Date of receipt of Decision or Director’s Order (yyyy/mm/dd):

Applying for Stay? Yes No

If Yes, outline the reasons for requesting a stay:

There are required documents and materials to be submitted to the Ontario Land Tribunal (OLT) based on the type of legislation and section you are filing under. Please see the Section 4A Checklist(s) located here and submit all documents listed on the checklist.

Are you filing an Application for Leave to Appeal under the Environmental Bill of Rights, 1993? Yes No

Identify the portions of the instrument you are seeking to appeal:

Identify the grounds you are relying on for leave to appeal. Your grounds should include reasons why there is good reason to believe that no reasonable person, having regard to the relevant law and to any government policies developed to guide decisions of that kind could have made the decision; and why the decision could result in significant harm to the environment:

Outline the relief requested:

There are required documents and materials to be submitted to the Ontario Land Tribunal (OLT) based on the type of legislation and section you are filing under. Please see the Section 4B Checklist(s) located here and submit all documents listed on the checklist.

Development Permit Application File No:

Address or legal description of the subject property:

Reasons for Appeal: Outline the nature and reasons for your appeal. Specific planning, environmental and/or other reasons are required. (The Niagara Escarpment Plan is available on the Niagara Escarpment Commission’s website (www.escarpment.org))

List the subject Mining Claim Number(s) (for unpatented mining claims) and accompanying Townships, Areas and Mining Division(s) where mining claims are situated. List all “Filed Only” Mining Claims, if appropriate: (This is to be completed for Mining Act appeals only.)

List the Parcel and the Property Identifier Numbers (PIN), if rents or taxes apply to mining lands, if appropriate (mining claims only):

Provide the date of the Decision of the Conservation Authority or the Provincial Mining Recorder, as appropriate:

Provide a brief outline of the reasons for your application/appeal/review. If other lands/owners are affected, please include that information in the outline being provided below:

Conservation Authority:

Contact Person:

Email Address:

Daytime Telephone Number: ext.

Alternative Telephone Number:

Mailing Address or statement of last known address/general area they were living and name of local newspaper if address is not available

Unit Number: Street Number:

Street Name:

P.O. Box:

City/Town:

Province:

Country: Postal Code:

There are required documents and materials to be submitted to the Ontario Land Tribunal (OLT) based on the type of legislation and section you are filing under. Please see the Section 6 Checklist(s) located here and submit all documents listed on the checklist.

Please see the attached link to view the OLT Fee Chart

Total Fee Submitted: $

Payment Method:

Certified ChequeMoney OrderLawyer’s general or trust account chequeCredit Card

If you wish to pay the appeal fee(s) by credit card, please check the box above and OLT staff will contact you by telephone to complete the payment process upon receipt of the appeal form.

DO NOT INCLUDE YOUR CREDIT CARD INFORMATION ON THIS FORM. YOU WILL BE CONTACTED TO COMPLETE YOUR PAYMENT OVER THE PHONE.

If a request for a fee reduction is being requested, please pay the minimum filing fee for each appeal and complete/submit the Fee Reduction request form

Request for Fee Reduction form is attached (if applicable – see Appeal Form Guide for more information)

I solemnly declare that all the statements and the information provided, as well as any supporting documents, are true, correct and complete.
By signing this appeal form below, I consent to the collection of my personal information.

Personal information or documentation requested on this form is collected under the authority of the Ontario Land Tribunal Act and the legislation under which the proceeding is commenced. All information collected is included in the Ontario Land Tribunal (OLT) case file and the public record in this proceeding. In accordance with the Freedom of Information and Protection of Privacy Act and section 9 of the Statutory Powers Procedure Act, all information collected is available to the public subject to limited exceptions.

We are committed to providing services as set out in the Accessibility for Ontarians with Disabilities Act, 2005.
If you have any accessibility needs, please contact our Accessibility Coordinator at OLT.Coordinator@ontario.ca or toll free at 1-866-448-2248 as soon as possible.

You must file your Appeal Form with the appropriate authority(s) by the filing deadline.

NOTE: Please review the notice of the decision you are appealing to determine the appeal deadline and the specific official with whom the appeal should be filed (e.g. Secretary-Treasurer, Clerk, Minister, Ontario Land Tribunal).

NOTE: Relevant portions of the applicable legislation should be reviewed before submitting this form. Please ensure that a copy of this Appeal Form is served in accordance with the requirements of the applicable legislation.