Municipal Sign Permit Application

City of Kawartha Lakes
Development Services Building Division
180 Kent Street West
Lindsay ON K9V 2Y6
Telelephone: 705-324-9411 extension 1288
Fax: 705-324-5514
Email: lferguson@kawarthalakes.ca

This form is not submitted electronically. A PDF will be emailed to the email provided. Please print and sign that copy and submit with your permit application package.

Owner Information:

Applicant Information:

Mobile Sign Information:

Trade Show Sign Information:

Project Information:

Please provide all measurements in metric.

Sign Structure Size:

Lot Size:

Property Setbacks:

Complete as if standing on the road in front of the property.

All of the statements and representations contained in the attached documents filed in support of this application shall be deemed part of this application for all purposes. Sufficient information shall be submitted with each application to enable the City of Kawartha Lakes to determine whether or not the proposed work will conform with all applicable by-laws.

Please Note: Upon completion of this form a signed copy must be submitted to the Building Division accompanied by a site plan showing location of sign in relation to property lines, hydro lines, underground utilities, septic bed/tank and other structures.

Declaration of Applicant/Owner:

I, the undersigned, .............................................. am the authorized owner/agent of the owner named in the above application and I certify the truth of all the statements or representations contained therein.

I understand that the issuance of a permit shall not be deemed a waiver of any of the provisions of the by-laws, notwithstanding anything included in or omitted from the plans or other material filed in support of or in connection with the above application.

I acknowledge that in the event a permit is issued, any departure from specific conditions, plans, specifications or building locations proposed in the above application is prohibited and such could result in the permit being revoked.

I further acknowledge that in the event the permit is revoked for any cause or irregularity or non-conformity with by-laws, there shall be no right of claim whatsoever against the City of Kawartha Lakes or any official thereof and such claim is hereby expressly waived.

__________________________________________          ______________________

Signature of Owner/Authorized Agent                                 Date

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.