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Required fields are marked with asterisks (*)

Consent or Severance Application

An application under Section 53 of The Planning Act.

Notice of Public Record 

All information and materials required in support of your application shall be made available to the public, as indicated by Section 1.0.1 of The Planning Act, R.S.O. 1990, C.P.13.

Notice of Collection

(Municipal Freedom of Information and Protection of Privacy)

Personal information on this form is collected under the legal authority of the Planning Act, and will be used to process this application. Questions about this collection may be directed to the Freedom of Information and Privacy Coordinator at 500 George Street North, Peterborough, Ontario K9H 3R9 or at 705-742-7777, ext. 1820.

Submission of this application constitutes consent for authorized municipal staff to enter upon the subject property for the purpose of evaluating the merits of this application.


  • If the applicant is not the owner of the land that is the subject of this application, written authorization of ALL registered owners authorizing the applicant to make the application must be included with this form.
  • The applicant shall attach a plan (and where required by the Committee of Adjustment, such plan shall be signed by an Ontario Land Surveyor) that shows:
    • the boundaries and dimensions of the subject land
    • the location, size and type of all existing and proposed buildings and structures on the subject lands, indicating the distance of the buildings and structures from the front, rear, and side lot lines
    • the approximate location of all natural and artificial features on the subject land and on land that is adjacent to the subject land that, in the opinion of the applicant, may affect the application (such as buildings, railways, roads, watercourses, drainage ditches, river or stream banks, wetlands, wooded areas, wells and septic tanks)
    • the current uses of land that is adjacent to the subject land
    • the location, width and name of any roads within or abutting the subject land, and whether it is an unopened road allowance, a public travelled road, a private road, or a right- of-way
    • if access to the subject land is by water only, the location of parking and docking facilities to be used
    • the location and nature of any easement affecting the subject land

Sample Sketch

Review a sample sketch before submitting your application.

Fee Calculation

Once staff have reviewed your submission, you will receive an email with a summary of the Application Fees owing, including the Otonabee Conservation ORCA Plan Review Fees.

Committe of Adjustment Schedule

The Committee of Adjustment hearing schedule is available on the City's website.

Have you contacted a City Planner to discuss your proposal before submitting your application?