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:

First:

Last:

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

check one

Of:

(prominent feature: closest intersection, utility pole, civic number, Bell pedestal number)

Civic No.:

Area marked by a stake / paint?

Yes

Will entranceway be paved in the future?

Yes

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

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.

Payment Information

Please include and submit with completed form.

Company:

First:

Last:

Permit requested:

Credit card type:

Visa

Mastercard

American Express

Credit card number:

Expiry:

Security code:

(3 digits on back of card)

Amount: $

Cardholder name:

Telephone:

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