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Application for Entranceway
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Application for Entranceway
Please submit the payment form with this application in the amount of $150.00. (Refundable should the application be denied.)
Please indicate Severance Application if applicable:
Date:
Name:
First:
Last:
Mailing address:
Address:
City/Town:
Province:
Postal Code:
Phone:
Fax:
Cell:
Email:
Entranceway Location Information
County road #:
Side of road:
Former township:
Lots:
Concession:
Municipality:
Specifically:
metres
Direction
N
S
E
W
check one
Of:
(prominent feature: closest intersection, utility pole, civic number, Bell pedestal number)
Civic No.:
Area marked by a stake / paint?
Yes
No
Will entranceway be paved in the future?
Yes
No
Purpose of application:
Purpose of application:
A new entranceway
An alteration or addition to an existing entranceway
Reclassification of entranceway
Relocation of existing entrance (this is classified as new which will require new pipe)
Classification of Entranceway
Classification of entranceway:
Residential
Agricultural - Farm
Agricultural - Field
Commercial (including Bell, Hydro or Gas)
Temporary
Reclassification
Other…
Enter other…
From:
To:
Please have your contractor provide proof of insurance - minimum coverage of $2,000,000 - commercial general liability. A permit will not be issued until our office receives proof of coverage.
Proposed work will be constructed by the following contractor:
Name:
Contractor:
Telephone/cell:
Fax:
I/We hereby apply to the Corporation of the United Counties of Stormont, Dundas & Glengarry for permission to construct, alter, change the use of the entranceway described above and do hereby agree to conform to the Counties' conditions, standards and specifications governing entranceways.
I/We hereby apply to the Corporation of the United Counties of Stormont, Dundas & Glengarry for permission to construct, alter,
change the use of the entranceway described above and do hereby agree to conform to the Counties' conditions, standards and
specifications governing entranceways
I declare that I understand the contents of
By-law 5122
.
By-Law 5122
A BY-LAW to regulate the installation and usage of entranceways and pipes and to prohibit the obstruction of certain drains.
WHEREAS Part II Section 11 Table of The Municipal Act, R.S.O. 2001, assigns the whole sphere of Highways to Upper Tier municipalities that have highways, and
WHEREAS Part II Section 11 Table of Municipal Act R.S.O. 2001 assigns collection of storm water and other drainage from land to Upper Tier Municipalities, and
WHEREAS it is deemed expedient to regulate the installation and use of entranceways and pipes over ditches and water courses upon or providing outlet to any highway forming part of the County Road System of the Corporation of the United Counties of Stormont, Dundas and Glengarry and to protect the outlet of these ditches and watercourses.
NOW THEREFORE the Council of the Corporation of the United Counties of Stormont, Dundas and Glengarry enacts as follows:
That the installation and usage of entranceways and pipes conform to the requirements set out in Schedule 'A' of this By-law.
That By-law 4676 and Roads Policy 2-2 be hereby rescinded
That this By-law come into force and effect on the passing thereof.
READ and passed, signed and sealed in open Council this 21st day of August 2017.
I solemnly declare that all the statements contained in this application and all the supporting documents are true.
I solemnly declare that all the statements contained in this application and all the supporting documents are true.
Payment Information
Please include and submit with completed form.
Company:
Name:
First:
Last:
Permit requested:
Credit card type:
Visa
Mastercard
American Express
Credit card number:
Expiry:
Expiry:: Year
Year
1900
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Expiry:: Month
Month
Jan
Feb
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Security code:
(3 digits on back of card)
Amount:
$
Cardholder name:
Telephone: