Brownfield Tax Exemption Application

Supporting documents referenced in this application form:

Brownfield Tax Incentive Bylaw C15-22
Appendix "A"
Appendix "B"

Application Type

First Application

Reapplication

Application Date:

Application #: (Internal Use Only)

#1 — Applicant Information

Applicant/Company Name(s):

Contact Name (if different than Applicant):

Applicant Address:

E-Mail Address:

Phone Number: (Primary)

Phone Number: (Alternate)

#2 — Property/Project Information

Property Address:

Legal Description:

Lot:

Block:

Plan:

Is the property located within the City of Fort Saskatchewan?

Yes

No

Is the property located within the boundaries of Eligible Property (as identified as Appendix “A”)?

Yes

No

Does this project align with the definition of New Construction included in the Brownfield Tax Incentive Bylaw C15-22?

Yes

No

Does the Project result in the construction of a minimum of:

a) 6 new Dwelling Units per Multi-unit Development?;

Yes

No

b) 3 new Dwelling Units above ground-floor commercial per Mixed Use Development?; or

Yes

No

c) 50% of the total area (m²) of the Project consists of Dwelling Units?

Yes

No

Is the project a minimum of 2 storeys?

Yes

No

#3 — Project Information

Project Name:

Project’s estimated capital cost ($CAD):

Project’s estimated construction start date:

Project’s estimated commercial operation date:

Has a Development Permit been issued by the City of Fort Saskatchewan for this project?

Yes

No

Has the construction of the Project commenced?

Yes

No

#4 — Legal and Financial Information

Is/has the applicant, company or venture:

gone through foreclosure?

Yes

No

the Assessed Person, or the authorized agent for the Assessed Person for the subject property?

Yes

No

subject to a stop order, pursuant to section 645 of the Act?

Yes

No

obtained or will obtain all necessary City development permits/approvals?

Yes

No

in violation of a City development agreement or of the Safety Code Act?

Yes

No

in arrears or have amounts owing with regard to property tax, utilities, or other fees to the City?

Yes

No

in bankruptcy or receivership?

Yes

No

in compliance with terms and conditions or any grant or other ﬁnance assistance from the City?

Yes

No

provided false information or misrepresented the facts within the application, application process or during the term of the Tax Incentive Agreement?

Yes

No

subject of an application or grant under the City's development grants program?

Yes

No

involved in litigation with the City?

Yes

No

Describe the Project’s purpose and beneﬁts (less than 500 words): Additional information may be included under “Appendix B” of application:

Describe the project type, such as Mixed-Use Development, Multi-Unit Development, number of Dwelling units, etc. (less than 500 words):

Provide the projected eligible capital cost of the project (less than 500 words):

Provide any additional comments or information about the project, or include under “Appendix B” of application:

File Upload for Supporting Documents:

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#5 — Application Requirements

I am authorized to bind the corporation under the terms of this application?

Yes

No

If the applicant is not an individual, an agent authorization form or directors’ resolution must be enclosed with this application. Is this authorization enclosed?

Yes

No

N/A

I acknowledge the requirement to comply with the Brownfield Tax Incentive Bylaw C15-22.

Yes

No

A Certiﬁcate of Title for the property subject to this application dated within 60 days of the date on the application must be provided. Is the Certiﬁcate of Title enclosed?

Yes

No

Applicant Representative Name:

Title:

Applicant Signature(s):

Clear

Applicant Signature(s):

Clear

Collection and use of information:
This information is collected under the authority of Section 33(c) of the Freedom of Information and Protection of Privacy Act (Act) and will be used in the management and administration of the City of Fort Saskatchewan’s Brownfield Tax Incentive program. Information related to this application may be disclosed as permitied or required by the Act. If you have questions or concerns about the collection, use or disclosure of your information, please contact the City’s FOIP Coordinator at 780-992-6200 or 10005-102 Street, Fort Saskatchewan, Alberta, T8L 2C5.

For Internal Use:

Application Review:

Decision:

Approved

Denied

Approval by:

Name:

Title:

Signature:

Date:

Appeal of Decision:
The applicant may appeal a decision to the Assessment Review Board pursuant to the City of Fort Saskatchewan Brownfield Tax Incentive Bylaw C15 -22.

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