BOARD OF VARIANCE PERMIT APPLICATION FORM PROPERTY

Planning Department
2205 Otter Point Rd., Sooke B.C., V9Z 1J2
Tel: 250.642-1634 Fax: 250.642-0541
www.sooke.ca
BOARD OF VARIANCE PERMIT APPLICATION FORM
** Applicants are advised to consult with Planning Staff before submitting an application.
This application is submitted for the following:
 Board of Variance
DESCRIPTION OF PROPERTY
Street Address:
________________________________________________________________________
Legal Description: Lot ___ Block ___ Section ____ Plan __________ Except ________________________
_________________________________________________________ ______________________________
Property Size: ___________________________________________________________________________
APPLICANT’S CONTACT INFORMATION - Please print clearly

Check if APPLICANT is the sole OWNER, if not complete Owner’s Authorization Form - attached
Name
Address
City
Email
Tel
Province
Cell
Postal Code
Fax
DESCRIPTION of the proposed variance and why the current bylaw requirements are presenting
hardship: (Attach a separate page if necessary)
__________________________________________________________________________________________
__________________________________________________________________________________________
PROPERTY DETAILS
Current Zoning:
__________________________ Current OCP Designation:
_________________________
Adjacent Land Uses: N_________________ S ________________ E _________________ W _______________
Within 30m of watercourse (stream, lake, wetland, etc?) or top of ravine bank? ___________________________
Within 15m of the high water mark of Sooke Harbour or Basin? _______________________________________
1st Proposed Variance: _______________________________________________________________________
2nd Proposed Variance: ______________________________________________________________________
3rd Proposed Variance: ______________________________________________________________________
4th Proposed Variance: _______________________________________________________________________
Other enactments of the District of Sooke, the Province of British Columbia and the Government of Canada may apply to
development affected by this bylaw. Applicants should satisfy themselves that all regulatory requirements affecting their proposal
are met.
FREEDOM OF INFORMATION NOTICE: Personal information contained on this form is collected under the Freedom of
Information and Protection of Privacy Act and will be used for the purpose of processing this application and for municipal
statistics. Enquiries about the collection or use of information on this form may be directed to the Deputy Clerk.
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Planning Department
2205 Otter Point Rd., Sooke B.C., V9Z 1J2
Tel: 250.642-1634 Fax: 250.642-0541
www.sooke.ca
FEES
Board of Variance
Permit
Application Fee
Fee per Public Meeting
Each Additional
Variance
$500
$200
n/a
Preparation of
covenant or other
legal document
required under
bylaw
Covenant
amendment
+actual cost plus $100 per document
$200 per document
AUTHORIZATION
WASTE MANAGEMENT ACT: I, the applicant and/or owner, represent and warrant to the District of Sooke, knowing that the
District of Sooke relies on this representation and warranty, that the property covered by this application has never, to the best of
my knowledge having made due and diligent inquiry, been used for any purpose such that a site profile is required to be
submitted under the British Columbia Waste Management Act and that the property is not contaminated or polluted in any way
that would make it unlawful, unsafe or unsuited for the purpose for which it is to be used, including within the meaning of the
British Columbia Waste Management Act.
I have read and agree to the above paragraph __________ (initial)
WAIVER AND INDEMNITY: I, the applicant and/or owner, assume all risks incidental to this application and agree to release,
save harmless and indemnify the District of Sooke and its officials, agents, servants and representatives, from and against all
claims, actions, costs, expenses and demands with respect to the death, injury, loss or damage to persons or property arising
out of or in connection with this application. I agree to conform to all applicable bylaws. I understand that no warranty is implied
for the approval of this application and that this waiver and indemnity is binding on me, my heirs, executors and assigns.
I have read and agree to the above paragraph __________ (initial)
The undersigned owner/authorized agent of the owner (Owner’s Authorization Form attached) makes an application as
specified herein, and declares that the information submitted in support of the application is true and correct in all respects.
Applicant’s Signature
Date
Other enactments of the District of Sooke, the Province of British Columbia and the Government of Canada may apply to
development affected by this bylaw. Applicants should satisfy themselves that all regulatory requirements affecting their proposal
are met.
FREEDOM OF INFORMATION NOTICE: Personal information contained on this form is collected under the Freedom of
Information and Protection of Privacy Act and will be used for the purpose of processing this application and for municipal
statistics. Enquiries about the collection or use of information on this form may be directed to the Deputy Clerk.
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Planning Department
2205 Otter Point Rd., Sooke B.C., V9Z 1J2
Tel: 250.642-1634 Fax: 250.642-0541
www.sooke.ca
INFORMATION REQUIREMENTS
Required
A. STATE OF TITLE CERTIFICATE – Dated
within 30 days of the application and include
copies of all non-financial charges on title (ie.
covenants, easements, right-of-ways, etc.).
B. SITE PLAN – Three copies drawn to scale
(metric), and one reduced 8.5” x 11” Site
Plan, showing:
 Civic address and legal description
 A survey plan confirming the dimensions
and setbacks of existing and proposed
buildings, structures and utilities
 Lot area and lot coverage
 Dimensions of the property lines, right of
ways, easements
 Location of high water mark or top of
bank of watercourses and riparian areas
(if applicable) or location of SPEA if
Riparian Area Assessment has been
completed
May be Required by District Staff
 That the site plan include location of existing
and proposed access, sidewalks, path,
curbs, boulevards, edge of pavement and
transit stops, location of numbering and
dimensions of all vehicle and bicycle parking,
manoeuvring aisles, vehicle stops and
loading bays.
 Contour plan with existing and proposed
contours at 0.5m intervals.





Archaeology Study
Ecological Study
Rainwater management plan
Riparian Area Assessment Report
Other reports or assessment necessary to
evaluate the Board of Variance Application
 Location and grade of steep slopes (>
30%)
 Location of all existing and proposed
water lines, gas lines, wells, septic fields,
sanitary sewer and storm drain facilities
 Scale bar and north arrow
 Adjacent property uses
C. A BRIEF DESCRIPTION of the proposed
variance and why the current bylaw
requirements are presenting hardship
Other enactments of the District of Sooke, the Province of British Columbia and the Government of Canada may apply to
development affected by this bylaw. Applicants should satisfy themselves that all regulatory requirements affecting their proposal
are met.
FREEDOM OF INFORMATION NOTICE: Personal information contained on this form is collected under the Freedom of
Information and Protection of Privacy Act and will be used for the purpose of processing this application and for municipal
statistics. Enquiries about the collection or use of information on this form may be directed to the Deputy Clerk.
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Planning Department
2205 Otter Point Rd., Sooke B.C., V9Z 1J2
Tel: 250.642-1634 Fax: 250.642-0541
www.sooke.ca
OWNER’S AUTHORIZATION FORM
All property owners registered on the Certificate of Title must provide written approval to allow
the APPLICANT to act on their behalf.
______________________________________, is hereby authorized to act as my agent for the
purpose of___________________________________________, located at:
Street Address: __________________________________________________________
Legal Description: Lot ___ Block ___ Section ____ Plan __________ Except
________________________________________________________________________
REGISTERED OWNER 1
Name of Registered Owner:___________________________________________________
Signature of Registered Owner: _______________________________________________
Date:____________________
REGISTERED OWNER 2
Name of Registered Owner:___________________________________________________
Signature of Registered Owner: _______________________________________________
Date:____________________
REGISTERED OWNER 3
Name of Registered Owner:___________________________________________________
Signature of Registered Owner: _______________________________________________
Date:____________________
REGISTERED OWNER 4
Name of Registered Owner:___________________________________________________
Signature of Registered Owner: _______________________________________________
Date:____________________
Other enactments of the District of Sooke, the Province of British Columbia and the Government of Canada may apply to
development affected by this bylaw. Applicants should satisfy themselves that all regulatory requirements affecting their proposal
are met.
FREEDOM OF INFORMATION NOTICE: Personal information contained on this form is collected under the Freedom of
Information and Protection of Privacy Act and will be used for the purpose of processing this application and for municipal
statistics. Enquiries about the collection or use of information on this form may be directed to the Deputy Clerk.
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