Agreement To Pay Non-Refundable Deposit
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22205 Otter Point Road, Sooke B.C., V9Z 1J2
Tel: 250-642-1634 Fax: 250-642-0541
AGREEMENT TO PAY NON-REFUNDABLE DEPOSIT
I, Name:
_______________________________________________________________
Address:
_______________________________________________________________
(Applicant)
Agree to pay the amount of $___________ as a non-refundable deposit towards the installation
described as:
___________________________________________________________________________
___________________________________________________________________________
This payment is made pursuant to section 7.2 of Bylaw No. 404, Subdivision and
Development Standards Bylaw, 2014 and section 4.3 of Schedule 1 of Bylaw No. 404,
Subdivision and Development Standards Bylaw, 2014, and is made in lieu of construction of
the Works and Services as itemized on the attached form identified as "Estimate of Non-
Refundable Deposit".
This payment is made as full compensation for the itemized works and services and fulfills all
the requirements of the Subdivision and Development Standards Bylaw, 2014.
EXECUTED on behalf of the District and the Owner this ______day of ________________
, 20____.
THE CORPORATE SEAL of the
)
DISTRICT OF SOOKE was hereunto
)
affixed in the presence of:
)
c/s
)
______________________________
)
Mayor
)
)
______________________________
)
CAO
)
SIGNED, SEALED AND DELIVERED )
_________________________
in the presence of:
)
OWNER
)
Print Name:
)
)
______________________________
)
_________________________
WITNESS
)
OWNER
______________________________
)
Print Name:
ADDRESS
)
______________________________
)
OCCUPATION
)
Non-Refundable Deposit – October 2014
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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