Required fields are marked with asterisks (*)

Development Services Building & Septic Division
180 Kent Street West
Lindsay ON K9V 2Y6
Telephone: 705-324-9411 extension 1288
Fax: 705-324-5514
Email: buildingadmin@kawarthalakes.ca

Municipal Farm 911 Field Entrance Sign Application

This form is to be used when ordering a yellow field entrance sign not associated with a building permit.

Requestor's Name:

Requestor's Phone Number:

Email Address of Requestor:

Street Name:

Road Name at Access Point:

Property Owner Name:

Assessment Roll Number - found on your tax bill:

Type of Sign Being Ordered

Blade only (requestor to install)

Post & Blade (includes installation by CKL)

Replacement of existing green field entrance sign with yellow Farm 911 sign

Number (Replacement only):

Mandatory:

A site sketch is required to accompany your application, clearly showing the location of the field entrance and the nearest cross roads and existing neighbouring numbers.

Upon completion of this form a signed copy must be submitted to the Building & Septic Division in conjunction with a site sketch and the appropriate fee.

Acknowledgement

The information provided on this form is true to the best of my knowledge. I have authority to act on behalf of the owner, corporation or partnership with respect to this application (if applicable).

This application is approved on the understanding that the Municipal Farm 911 Field Entrance Sign is to assist in emergency situations and ease of wayfinding only.

An approved application does not imply that use of the property may proceed without additional permits or approvals as required by the City of Kawartha Lakes and further does not constitute an approval of an entrance unless so directed by the City of Kawartha Lakes.

It is the responsibility of the land owner to ensure signage is placed, remains visible and is maintained according to the signage criteria provided by the City of Kawartha Lakes. If the sign is knocked down or damaged it is the responsibility of the land owner to purchase a replacement sign using the above process.

Date submitted

Signed by

Clear

Print, sign and submit this form and required sketch to the Building & Septic Division, via email, drop off at any municipal Service Centre, mail to the address at the top of this form or alternatively email to buildingadmin@kawarthalakes.ca

For more information on filing applications or making payments please visit the City website at www.kawarthalakes.ca and navigate to My Property page under the Living Here tab.

Personal information contained on this form is collected pursuant to the Municipal Act, 2001 and will be used for the purpose of responding to your request. Questions about the collection of this information should be directed to the City Clerk or Deputy-Clerk at clerks@kawarthalakes.ca.

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