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Entrance Construction Permit Application

This form is authorized under the Driveway, Entrance and Boulevard By-law 2022-31

 

A. Project Information

B. Purpose of application

Select all that apply:
 

Please enter N/A if not applicable:

C. Applicant/Contractor

D. Owner (if different from applicant)

E. Checklist

Select all that apply (please note that the fee/deposit is to be paid at the Township Office, 318 Canborough St, Smithville, ON, L0R 2A0):
 

F. Declaration of applicant

1. The information contained in this application, attached schedules, attached plans and specifications, and other attached documentation is true to the best of my knowledge.

2. If the owner is a corporation or partnership, I have the authority to bind the corporation or partnership.

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Conditions of Approval

THIS PERMIT IS SUBJECT TO THE FOLLOWING CONDITIONS AND TO ANY SUPLLEMENTARY CONDITION ESTABLISHED BY THE TOWNSHIP AT THE TIME OF ISSUE:

1. This entrance permit is subject to all applicable Municipal By-laws.

2. Work on the construction or alteration of an entrance must not be started before an entrance permit for the work has been issued by the Township.

3. New entrances, entrance extensions/widenings and curb cuts/fills are the responsibility of the property owner.

4. Maintenance and/or replacement of existing entrance culverts will be determined by Township Staff. If repairs/replacement are recommended, those works will be completed by Township staff.

5. All works related to or forming a part of an entrance shall be carried out in accordance with the approved plans and specifications and subject to the approval of the Township. The owner of the property shall bear all expense and liability related thereto.

6. Trees, shrubs, etc. on the right-of-way and a highway must not be cut or trimmed without the written permission of the Township and such cutting or trimming may only be done under the direct supervision of the Township or its duly authorized agent; where it is necessary to cut or trim trees on property adjacent to a highway, the applicant must make the necessary arrangements with the property owners and must bear all expenses and liability in connection therewith, including any damages occasioned as a result of such cutting or trimming.

7. An entrance permit may be cancelled at any time for breach of the regulations or conditions of the permit or for such reasons as the Public Works Department in their discretion deems applicable.

8. The applicant agrees for himself/herself, itself, his/her/its heirs, executors, successors and administrators to indemnify and save harmless the Corporation of the Township of West Lincoln from any action, claim, damage, cost or loss whatsoever, arising from operations carried out under this permit.

9. A valid Certificate of Insurance, in a form acceptable to The Corporation of the Township of West Lincoln, with respect to liability for property damage and personal injury for a minimum amount of $2,000,000.00 for Residential permits, and $5,000,000.00 for Commercial/Industrial permits for any one accident or occurrence and the Certificate of Insurance shall name The Corporation of the Township of West Lincoln as additional insured or co-insured and remain in force until the Township approves the works.

10. When submitting the application, a copy of the Certificate of Insurance (as outlined in #9 above), a fee of $1405.00 (which includes a $155.00 application fee and $1250.00 deposit) and a sketch or map of the proposed entrance is required. If you are hiring a contractor to complete the work, a W.S.I.B. Clearance Certificate will also be required.

11. Utility locates are mandatory and are the sole responsibility of the applicant.

12. This permit is valid for a period of 1 year from Township approval.

Personal information collected will be used for the purposes indicated only in accordance with the Municipal Freedom of Information & Privacy Act. Questions regarding the collection of personal information may be directed to the Office of the Municipal Clerk.