Short Term Accommodation Owner Authorization Form

(Required only if a person other than the property owner is completing the application and may be contacted to discuss matters on behalf of the owner)

to submit a short term accommodation (STA) licence application pursuant to By-law 2021-84, for the above-noted address, along with any required supporting documentation, to the Municipality of Northern Bruce Peninsula, on my behalf. I hereby certify that I have reviewed the completed short term accommodation (STA) licence application, supporting documentation and declarations, confirm them to be true and correct, and agree to be bound thereby. I further declare that I understand it is my responsibility to ensure that this property is at all times in compliance with all applicable law, including but not limited to the Building Code Act, the Fire Protection and Prevention Act, the Electricity Act, and regulations made under them.

Privacy Notification: Personal information on this form is being collected for the purpose of determining the owner's eligibility for a Short Term Accommodation Licence in the Municipality of Northern Bruce Peninsula pursuant to its Bylaw(s). In providing this information, you have consented to its use for the above-described purpose and declare that all the information provided herein is correct. This information may be shared with applicable Municipality of Northern Bruce Peninsula departments and related agencies for the purpose of required inspections, approval of, and compliance with this licence application. The legislated authority to collect your personal information is the Freedom of Information and Protection of Privacy Act. If you wish to obtain further information regarding the collection of your personal information, please contact the Clerk's Department at clerk@northernbruce.ca