Schedule “B” Town of View Royal APPLICATION/CONSENT FOR AMENITY DONATION

Town of View Royal

I hereby make application for donation of an amenity item to the Town of View Royal.

Applicant’s Name: _________________________________________________

Applicant’s Mailing Address: _________________________________________

Applicant’s Phone Number: __________________________________________

Requested Item:___________________________________________________

Requested Location: _______________________________________________

Requested Wording on Plaque (if applicable): ____________________________

Additional Comments: ______________________________________________

(Date) (Applicant’s Signature)

Please note that all applications are subject to the approval of staff

Application/File No. _____________________

Approved Item/Location: ____________________________________________

Approved Plaque Wording: __________________________________________

Estimated Cost of Donation:__________________________________________

Other Information: _________________________________________________

(Date) (Signature of Official)

Donor Acceptance: yes / no

(Donor Signature) (Signature of Official)

(Date) (Date)

The Town will proceed with purchase and installation of the amenity item following donor approval and receipt of funds in the amount of the cost estimate listed above.
Upon purchase, the amenity donation becomes the property of the Town of View Royal and is for the use and enjoyment of the general public. The donation of an amenity item does not constitute ownership of the item, the land upon which it is situated or the surrounding lands.
Placement of memorial wreaths, flowers or other items or any modifications to the amenity item are not permitted.
Donors will be notified of the option to renew their donation for one additional term six months prior to the expiry of the first term. Renewal charges will be concurrent with the fee schedule of the year in which the renewal occurs.