Information of permit holder

Contractor

If this field is left blank, the emergency contact will be the project manager.
______________________________________________________________

Work details proposed

Refer to the example above
_______________________________________________________________

Information about the location for the road cut

Location 1

__________________________________________________________________

Location 2

_______________________________________________________________

Traffic Management Information

In Compliance with the Ontario Traffic Manual (Book 7)

______________________________________________________________

Approvals, agreements, and consents

________________________________________________________

Professional service fees

________________________________________________________

Permit holder declaration

I understand that:

  • The total amount of fees will be provided to me in accordance with the professional service fees outlined in the municipal by-law of the Town of Hawkesbury.
  • The fees do not include testing services or any other necessary services. These additional costs will be added to the associated fees.
  • Fees may be adjusted depending on the nature and complexity of the project.
  • All fees must be paid before the permit is issued by the Town.
  • Fees must be paid in person at Town Hall, either by cheque, debit, or cash.

Please note: The permit is valid for one year from the date of issuance. After this date, a new permit must be requested, which will also include the applicable issuance fees.

I acknowledge

  • That as the permit holder, I am responsible for ensuring that the conditions of this agreement are respected by myself and by any person working on my behalf.
  • That all individuals involved in this project must comply with Road Activity By-law No. 2003-445. Each person must adhere to municipal regulations and work diligently with the staff of the Town of Hawkesbury.

I declare that all information provided in this application, including any attachments, plans and estimates, and any other documents, is accurate to the best of my knowledge.

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