Property Inquiry Form - Crowe Valley Conservation

CVCA File #: PI Date Received:
P.O. Box 416, 70 Hughes Lane, Marmora, ON K0K 2M0
Tel: 613-472-3137 Fax: 613-472-5516 www.crowevalley.com
Property Inquiry Form
PLEASE anticipate a minimum of two weeks for a response and plan accordingly.
Please note that all information must be completed on this form and be legible. Incomplete information may cause delays or an inaccurate response.
If this is a legal inquiry to fulfill a condition of a real estate purchase, please contact our office directly.
Contact Information
First Name
Last Name
Mailing Address (Street, P.O. Box)
City
Telephone: Home
Postal Code
Work
Mobile
Email
Inquiry Made By:
Property Owner
Real Estate Agent
Potential Purchaser
Agent for Property Owner
Other
Please explain:
Is the Owner aware of this application?
Yes
If no, please explain:
Property Location
Lot
Concession
Municipality
Municipal Street Address
(i.e.- 70 Hughes Lane)
Assessment Roll Number
(19 digit number found on your property assessment notice)
Watercourse/Waterbody
No
Reason for inquiry
Potential Property Purchase
General Property Inquiry (Am I within the regulated area?)
Construction, reconstruction or placing a building/structure
Placement or removal of fill, including septic installation or replacement
Straightening, changing, diverting or interfering with a watercourse, shoreline or wetland
Natural features on or near property (please check all that apply)
Watercourse
Shoreline
Wetland
Inland Pond
Steep Slope
Other:
Provide a brief description of the proposal and/or any questions and concerns
Information you provide on this form is collected by the Crowe Valley Conservation Authority (CVCA) in accordance with
the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA) and will not be used for any purpose other
than for responding to the specific property inquiries contained in this form. The information you receive from this
request is for your convenience only.
This inquiry does NOT constitute an Application for a Permit under Section 28 of the Conservation Authorities Act, R.S.O.
1990 Chapter C27.
Date:
Please submit your completed form to [email protected]