Entrance Permit Application
Municipal Office
RR # 1, 1092 Hwy. 595
ON P0T 1W0
Application for private entrance and/or culvert.
| Name of owner: __________________________________________ |
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| MailingAddress: ___________________________________________________ |
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| Phone: ____________________________ |
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| Legal description of property: |
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| Lot number: ___________ Plan and/or Concession:________________ | |
| Street/Road name: ________________________________________ |
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| Note: A separate application must be submitted where more than one entrance or culvert is intended to be installed to serve one and the same property. |
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| It is understood by the applicant that the construction of an entrance or the installation of a culvert herein applied for shall be constructed and/or installed in accordance with the directions of the Municipality , and any entrance culvert constructed and/or installed without the written consent of the Municipality shall be subject to removal forthwith at the expense of the applicant. (Clause 9, By-law 318, passed on the 5 th day of August 1982.) |
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| Date: _______________ |
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| Signature of owner: _____________________________ |
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| The above application covering permission to install one ______________________ |
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| has ________ been approved. |
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| Subject to the following conditions: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ |
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| Date:______________________ |
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| Road Superintendent signature:________________________________ |
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