HomeMy WebLinkAbout2025-08-28 FORM A1 Home Based Business 2 Application fillableFORM A1: HOME BASED BUSINESS 2 APPLICATION
A completed Development Permit Application must be submitted in addition to this form.
County of Newell | Home Based Business 2 Application | Land Use Bylaw 2016-21 Page 1 of 2
183037 RR145 (Box 130), Brooks, AB T1R 1B2
Office Hours: Mon-Fri 8:00 a.m. – 4:30 p.m.
Email: development@newellmail.ca
Web: www.countyofnewell.ab.ca
Phone: 403-362-3266
Permit No.
Revised 2026-01-06
1.APPLICANT INFORMATION
Applicant Name:
2.DEVELOPMENT INFORMATION
a.Is there a Home Based Business currently operating on the site?
Yes No
If yes, what is the nature of the Home Based Business and associated development permit numbers:
____________________________________________________________________________________________
b.The proposed new Home Based Business will be:
On-site Off-site/Mobile
Describe the business, including the goods and/or services to be provided, and the other locations if off-site/mobile:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
c.The proposed new Home Based Business will operate:
In the dwelling In an accessory building
If the business is in the dwelling, attach a floor plan showing which rooms the business will use in its operation.
Attached floor plan Date: _____________________________
d.Operating Information:
Number of days per week: _________, from _____ to _____ (hours)
Number of resident employees: _______ Non-resident employees: _______
Anticipated customer visits: _______ per day/week/month (circle one)
Number of parking spaces for clients, employees, and deliveries _______
(show parking area on the Development Permit site plan with dimensions and number of stalls)
e.Are there any commercial vehicles/trailers that will be used in conjunction with the business?
Yes No
If yes, describe the number, type and size of all applicable vehicles/trailers:
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
County of Newell | Home Based Business 2 Application | Land Use Bylaw 2016-21 Page 2 of 2
Revised 2026-01-06
f.Are outdoor storage areas required?
Yes No
If yes, describe what is to be stored and show location(s) on the Development Permit Application site plan:
____________________________________________________________________________________________
____________________________________________________________________________________________
g.Are flammable or hazardous materials used for the business?
Yes No
If yes, list the type and quantity to be stored:
____________________________________________________________________________________________
____________________________________________________________________________________________
h.Are signs being installed for the business?
Yes No
If yes, complete Form A3: Sign Application and show on the Development Permit Application site plan:
____________________________________________________________________________________________
____________________________________________________________________________________________
3. DECLARATION OF APPLICANT / REGISTERED OWNER
The information given on this form is full and complete and is, to the best of my knowledge, a true statement of the facts in relation to the
application for a Home Based Business 2. I consent to an authorized person designated by the municipality to enter upon the subject land
and buildings for the purpose of an inspection during the processing of this application.
Date: _____________________ Applicant Signature: ______________________________________________
Registered Owner: _______________________________________________________________________________
(Required, if different from applicant) Print Name Signature
OR
Written approval has been submitted by the registered owner stating that the applicant is authorized to sign the application form.
Date written approval was submitted: __________________
Collection Statement: The personal information collected on this form will be used to process and issue permits and for safety codes compliance monitoring and verification. This collection is
authorized under section 4 (c) of the Protection of Privacy Act and will be protected by section 10 of the Protection of Privacy Act and section 63 of the Safety Codes Act. It will be used to
process the home based business application, prepare referral notifications if needed, and to contact the applicant when required. The name of the applicant and nature of the application
may be included on reports provided to the municipality or made available to the public as required or allowed by legislation. Please direct any questions about this collection to the Privacy
Officer for the County of Newell at 403-362-3266 or administration@newellmail.ca.