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THE CORPORATION OF THE CITY OF PORT COQUITLAM ee

"DEVELOPMENT PROCEDURES BYLAW, 1987, NO. 2243"
SCHEDULE ‘"C"
Enacted by Bylaw No. 2608
APPLICATION FOR

DEVELOPMENT PERMIT

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—

TO BE COMPLETED BY APPLICANT — Please print clearly FILE NO.

Applicant's hane Registered Owner

Address Address

Cinclude postal code) (include postal code)

Phone Number ; Phone Humber

egal Description of Property

o

Civic Description of Property

Proposed Use of the Property

(Deseribe New Construction Planned )

Size of Property

T/iie declare that our interest in the property described above’ is as follows:

Initials

Registered Owner or Purchaser under Registered Agreement for Sale

Holder of a’ Registered Option to Purchase

Holder of

‘

I am the agent of who holds the
interest I have indicated above.

(Date) -_ : (Signature)

“1 a nee npetnarepl teen erenmant ree oemeanepeyeyenprrerenrabaneclersarvtperet

TO BE COMPLETED BY OFFICE
Fee Paid — 700.00 *

* $400.00 Non-refundable processing fee RECEIPT #

$300.00 Document Fee (Refundable if project DATE
is net approved)

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