Request For Reconsideration Page 4
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Section 4: Residential property data
(continued)
Roll number
Have there been any
Yes
No
additions to the property?
Addition Area
Sq. Ft. (Exterior)
Addition Completion Date
Addition Storeys
1 Storey
2 Storeys
3 Storeys
Have there been any
Interior
Completion Year
Exterior
Completion Year
improvements or alterations
to the property since it was
Kitchen Modernization
Exterior Cladding
constructed?
Bathroom Modernization
Roof Surface
Wiring Upgrade
New Windows
New Heating System
Foundation
Plumbing Upgrade
Other:
Structural Changes
Other:
Building Permits
Have you been approved for a building permit for a new structure or a demolition in the last 3 years?
Yes
No (if yes, please provide details and completion date below)
Comments and/or Secondary Structure information
Please list any secondary structures (i.e. garages, sheds, in-ground pool) and include additional information relevant to the property.
Section 5: Signature of owner
X
Date (dd/mm/yyyy)
Section 6: Representative information
If you would like someone else to act for you while we review your RfR, please complete this section by indicating their
name below and providing a Letter of Authorization. You may also use the
available at
Representative Authorization Form
mpac.ca.
Name Representative (Last Name, First Name)
LSUC License Number
Telephone
A representative may act on behalf of a property owner. There have been recent changes to the
Law Society Act
with
respect to the requirements of who can act as a representative for a property owner. If you are not the owner of the
property, you must also supply a Letter of Authorization endorsed by the property owner stating that you are representing
the owner in this matter. Persons approved by the Law Society of Upper Canada to practice law or provide legal services
in Ontario do not require Letters of Authorization.
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