Application for a Name Bank Submission

Transcription

1 Application for a Name Bank Submission Introduction Are you interested in having a street, park or Town facility named after someone who has made a significant contribution to our community, province or country? Or, perhaps you have a suggestion for a name that has historical, community, geographical, ecological, functional or commemorative value to Milton residents. Members of the public are invited to submit names to be considered for the Town of Milton Name Bank. Names that meet specific criteria are stored in the Name Bank to be used for streets and Town-owned facilities, such as parks, buildings, woodlots, storm water management ponds and other amenities. This application form should not be used for submitting names associated with organizations, corporations or businesses. These names, as well as names that that do not meet any of the currently approved naming criteria, may be considered for donor/sponsorship opportunities, offered by the Town of Milton. For more information on donor/sponsorship opportunities, please call , ext Review process All submissions for the Name Bank are processed by the Community Services Department and reviewed by the Naming Conventions Committee. Submissions for street names require a detailed review by Town staff in the Planning & Development Department and Fire Department. Emergency Services also reviews proposed street names for the Name Bank to ensure there are no safety concerns related to streets being located quickly in the event of an emergency. All name submissions are reviewed for adherence to the approved naming categories, according to Town policy. Adding new name categories is subject to review by the Naming Conventions Committee and approval by Town Council. Submit your completed application as follows: Mail: Town of Milton, 150 Mary Street, Milton ON L9T 6Z5 Attention: Naming Conventions Committee, C/O Planning and Development Department Fax: In person: Town Hall Milton Leisure Centre Milton Sports Centre Milton Seniors Activity Centre Additional information: Web: namebank@milton.ca Phone: , ext P age Revised: December 2011

2 Getting ready to submit a name Before you start your application, please complete these two steps: 1. If you are submitting a name to be used only for a street, check Town of Milton existing street names to ensure the name you want to submit is not a duplicate: Visit select Live at the top of the page then Suggest a Street Name under Roads on the top left hand corner of the page. Then follow the instructions on the page. 2. Select the criteria that apply to the name you are submitting to the Name Bank, checking all that apply. (Please note that new criteria/categories may be added to this list in future.) Approved Street Name Categories Historic Contribution Recognition of individuals, families or businesses that have made a significant historic contribution to the Town of Milton and local history such as events, land use, cultural landscape (aboriginal, pioneer, ethnic diversity) relative to the Town of Milton and the Regional Municipality of Halton Acknowledgement of the Town s heritage resources, including heritage buildings, structures, sites, natural features and landscapes Community Relevance/Contribution Local citizens who have, or have had, substantial international standing in their chosen discipline An individual or organization that has made a significant contribution to the community (at a provincial or national level) Community, Military or Political Service Milton Chamber of Commerce Citizens of the Year and Lifetime Achievement Award Winners Former Presidents of the Halton Agricultural Society Fallen veterans of WWI and WWII as identified by the Royal Canadian Legion Former Prime Ministers of Canada Former Premiers of Ontario Former Governors General of Canada Former Lieutenant Governors of Ontario Federal Members of Parliament retired from public office who have represented Milton and area since 1867 Ontario Members of Parliament retired from active office who have represented Milton and area since 1987 Members of Milton Council retired from active office Local persons having served during the Fenian Raids Local persons having served in the South African War Local persons having served in the Korean War Local persons having served in World War I Local persons having served in World War II Former Chiefs of Milton Fire Department Former Milton Chief (Police) Constables Former Chairs of the Regional Municipality of Halton Former Judges and Sheriffs of Halton County Former Provincial Representatives of the Legislature of Canada West Former Federal Representatives of the Legislature of Upper Canada Former Lieutenant-Governors of Upper Canada, Canada West and / or Ontario Former Lieutenant-Governors of Canada 2 P age Revised: December 2011

3 Approved Facility Name Categories (Parks, Open Space, Municipal Buildings, Facilities) Recognize local history, e.g. families, events, land use (agricultural, mill), cultural landscape (aboriginal, pioneer, ethnic diversity) relative to the Town of Milton and the Regional Municipality of Halton Convey the geographic location of the facility including the name of the major street upon which the property fronts, neighbourhood name, planning name, Council-approved development area name Acknowledge an existing natural feature or landform, ecological relationship, scenic or tourist value, indigenous flora and fauna Reflect the service, function or programming of the site Support Town commemorative initiatives and celebrations programs, such as a twin city, millennium event, national event etc. Preference will NOT be given to names that: Cause confusion due to duplication or similarity to existing names May be interpreted as an advertisement Are discriminatory in nature Connote political affiliation Sponsorship Opportunities For names that don t meet any of the above criteria, please consider sponsorship opportunities. For more information, call , ext P age Revised: December 2011

4 Application for Name Bank Submission To: Naming Conventions Committee, C/O Planning & Development Department, Town of Milton, 150 Mary St., Milton, ON L9T 6Z5 Fax: Phone inquiries: , ext Date of submission: Applicant Information: Name: Mailing address: Town/City Postal code Telephone number: Day Evening address: Name Bank submission: Suggested name: Variations to name (Include full names, initials for consideration) Suggested use for name: Any use Specific use(s) only (Check all applicable categories.) Street Park or park element Building or building element Property or entry feature Woodlot Storm water management pond Other (Please specify: ) Any location: Specific location/address: 4 P age Revised: December 2011

5 The Town of Milton reserves the right to evaluate and process all submissions as per Town policy, and cannot guarantee if, or when, a submitted name will be used. Where applicable, the Town may require the consent of individuals, organizations or businesses as part of the Name Bank Application process. Consent of individuals: Consent is required for all names being proposed for individuals, families, organizations or businesses as follows: In Memoriam (Please complete Consent Form 1) Living Individuals, Organizations or Businesses (Please complete Consent Form 2) Please indicate the specific name selection criterion that is most appropriate for your submission (see page 2 for list of criteria): Reasons for submission: Please provide a brief summary outlining your reasons for submitting this proposed name to the Name Bank. Attach supporting information, such as historical records, photographs, date of birth, date of death, names of parents, profession, etc., to streamline the review of the proposed name. I hereby declare that all information included in this submission is true and correct to the best of my belief and knowledge. Signature: Date: 5 P age Revised: December 2011

6 Application for Name Bank Submission Consent Form 1 In Memoriam To: Naming Conventions Committee, C/O Planning & Development Department, Town of Milton 150 Mary St., Milton, ON L9T 6Z5 Fax: Phone inquiries: , ext Applicant information: Name: Mailing address: Town/City Postal code Telephone number: Day Evening address: Family / Executor of the Estate information (if different than applicant): Name: Mailing address: Town/City Postal code Telephone number: address: Family/Estate consent I,, hereby declare that I am duly authorized by the Family/Estate of to grant consent to to submit the name of for inclusion in the Name Bank, as maintained by the Town of Milton. It is my understanding that the Name Bank is maintained for the purpose of selecting names for use in the naming/renaming of Town-owned facilities and the naming of streets. For the purposes of the policy the term facility refers to Town-owned parks, property and buildings, or elements within the parks, properties or buildings. It is also understood that should the Naming Conventions Committee select the above submitted name, or a variation there of, and its use be approved by Town Council, no further permission beyond this consent must be sought from the family/estate. Signature of Applicant: Date Relationship to Deceased Individual: Signature of Authorized Family/Estate Representative ( if applicable): Date Relationship to Deceased Individual: 6 P age Revised: December 2011

7 Application for Name Bank Submission Consent Form 2 Living Individuals, Organizations, Businesses To: Naming Conventions Committee, C/O Planning & Development Department, Town of Milton 150 Mary St., Milton, ON L9T 6Z5 Fax: Phone inquiries: , ext Applicant information: Name: Street address: Town/City Postal code Telephone number: Day Evening address: Nominee information: Name: Mailing address: Town/City Postal code Telephone number: Day Evening address: Nominee consent: I,, hereby declare that I grant consent to to submit my name/my business name, for inclusion in the Name Bank, as maintained by the Town of Milton. It is my understanding that the Name Bank is maintained for the purpose of selecting names for use in the naming/renaming of Town-owned facilities and the naming of streets. For the purposes of the policy the term facility refers to Town-owned parks, property and buildings, or elements within the parks, properties or buildings. It is also understood that should the Naming Conventions Committee select the above submitted name, or a variation there of, and its use be approved by Town Council, no further permission beyond this consent must be sought from me. Signature of Nominee: Date Signature of Applicant: Date 7 P age Revised: December 2011