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Department Forms\Development Service\Subdivision Process\Form_Application_Subdivision_Chester Rev. 2021-08-30
APPLICATION FOR SUBDIVISION APPROVAL
File No: Municipality of the District of Chester
Schedule “A”
SUBDIVISION RELATED INFORMATION OF OWNER
Name o f Land Owner(s) _____________________________________________________________________________
Mailing Address o f Land Owner(s)______________________________________________________________________
Postal Code_______________ Phone N o.________________ Email_____________________________________
Subdivision Name (if different from owner) _______________________________________________________________
Documents T o B e Returned T o _______________________________________________________________
Correspondence T o B e Directed T o _______________________________________________________________
LAN D TO BE SUB D IV ID ED
Location ___________________________________________ Municipality CHESTER
Parcel Identifier(s) __________________________________
Type O f Application □ Preliminary (Optional) □ Concept (Optional) □ Tentative (Optional) □ Final □ Instrument □ Repeal
$200.00 Application Fee (6 or fewer lots) Attached (payable to Municipality of the District of Chester) □ Yes □ N o
$400.00 Application Fee (7 or more lots) Attached (payable to Municipality of the District of Chester) □ Yes □ N o
$113.35 Registration Fee (Migrated Property) (payable to Registry of Deeds) □ Yes □ No
$213.35 Registration Fee (Property Not Migrated) (payable to Registry of Deeds) □ Yes □ No
$100.00 Registration Fee (Repeals and Instruments) (payable to Registry of Deeds) □ Yes □ No
Type o f Development Proposed □ Single U nit D welling □ Other _______________________________________
(Specify)
Approval Requested For Lot(s) # ______________________________________________________________________
Assessment Requested Fro m Department O f T he Environment □ Yes □ N o
Dept. of Environment charges a fee for comments when more than 2 lots are involved. Please contact them prior to applying for subdivision
Is T here A Remainder Lot? □ Yes □ N o
C ERTIFIC A TIO N - O N -SITE SY STEM NO T REQ U IR ED (unserviced areas, greater than 9,00 0 square metres area, 76 metres
width) 96,878.4 sq. ft., 249.3 ft. width
I certify that ______________________________________________ (is, are) being subdivided for a purpose
(lot(s) being approved and/or remainder lot)
(__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ ) which will not require the installation of an on-site
(specify purpose)
sewage disposal system.
Signature ________________________________________________
W A TER SERV IC ES
Existing Proposed
Central System □ □
Drilled Well □ □
Dug Well □ □
Other ______________________________
(specify)
SEW ER SERV IC ES
Existing Proposed
Central System □ □
On-Site □ □
A CC ESS
Existing Proposed
Municipal Public Street □ □
Provincial Public Street □ □
Private Road □ □
Other ___________________________________
(specify)
I certify that I am the owner o r am acting with the owner's written consent.
Signature of Subdivider _____________________________________ D ate _____________________________