Application for Entranceway and Civic (911) Numbering

Address:
Is a civic number required?

Location

metres
Direction

Purpose of Application

Purpose

Classification of Entranceway

Classification
Payment in the amount of $100.00 (entranceway) and/or $75.00 (civic) (refundable should the application be denied) shall accompany this application.
Terms and conditions of permit for entranceway
Sign above
#
Date fee collected
$100.00 Entrance:
$75.00 Civic number:

Permission Granted and Approved Specifications

Entranceway Dimensions

Width of entranceway at ditch/curbine:
If a pipe is required, the pipe shall be new galvanized steel or plastic SP nominal thickness:
metres
mm
Upon submission of your completed form, please call the Township of North Dundas at 613-774-2105 to process payment, or visit us in person at 636 St. Lawrence Street, Winchester, Ontario K0C 2K0.