Required fields are marked with asterisks (*)

Town Development Charges Deferral Agreement Application Form

Note: Application for a partial/full deferral in accordance with By-law 2019-133

Applicant details

First Name

Last Name

Unit Number

Street Number

Street Name

P.O. Box Number/ RR Number

City or Town

Postal Code/ ZIP Code

Phone Number

Fax

E-Mail Address

Property details for deferral

Name of Registered Property Owner(s)

Municipal address

Same as above

Different to above

Property Roll Number

Legal Description

Building Permit #

Please refer to Development Charges By-law 2019-133 Schedule “B” and “C”.

Deferral is for...

Residential

Non-Residential

Collection of Information

The personal information contained on this form is collected under the authority of the Municipal Freedom of Information and Protection of Privacy Act. The information is collected to administer By-law 2019-133 (Development Charges) and By-law 2018-103 (Delegated Authority to Enter into Deferral Agreements for Development Charges), and may be provided to the Finance Department for the purposes of property tax administration and collection. Questions about this collection can be directed to the Clerk’s Department, Town Hall, 37 Main Street East, Huntsville, ON, P1H 1A1, 705-789-1751.

Authorization

I have read and understand all of the terms and obligations under section C.(d) of By-law 2019-133, as amended. I confirm that all of the information provided in and attached to this application is correct and I agree that approval of this Application is at the sole discretion of The Town of Huntsville. I acknowledge this agreement only pertains to the Town of Huntsville’s development charges and not the District of Muskoka’s development charges. A separate agreement needs to be obtained from the District of Muskoka.

Applicant Signature

Clear

Date

By checking Yes, I am attesting that the information provided on this form is true and correct and submitting is equivalent to my authorized signature.

Yes