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Application for Change of use

The Township of Gillies

R.R. #1, 1092 Hwy. 5958, Kakabeka Falls, ON P0T 1W0 (807) 475-3185   Fax (807) 473-0767

Application for Change of Use

 Building Permit

 

 

 Roll Number

 

 

 

 

 Owner Name

 

 Address

 

 Phone Number

 

 

 Site Location (if different from owner)

 

 Address

 

 Phone Number

 
 

Occupancy

Present Use

Proposed Use

BASEMENT

    

1ST FLOOR

    

2ND FLOOR

    

3RD FLOOR

    

Date Application Received

 

Applicant Signature


________________________________


________________________________


Permit Fee


Inspector Signature

________________________________
________________________________

 

Personal information contained on this form is collected pursuant to the freedom of information and protection of privacy legislation and will be used for the purpose of responding to your application.