Sign Permit

Required fields are marked with asterisks (*)

Notice of Collection of Personal Information

Personal information on this form is collected under the legal authority of Municipal Act, 2001. The delegate’s information is collected and maintained for the purpose of creating a record that is available to the general public, pursuant to Section 27 of the Municipal Freedom of Information and Protection of Privacy Act. This information is collected and maintained for the purposes of preparing an agenda for Council. Questions or concerns about the collection of this information can be directed to the Clerk at 4305 Hamilton Road, Dorchester ON N0L 1G3, Phone: 519-268-7334 ext 254 or clerk@thamescentre.on.ca

Project Information (where the sign is to be located)

Street Number

Street Name

City/Town

Postal Code

Type of Business

Zoning Category

Type of Sign(s) to be Erected

Pole

Fascia

Ground

Portable

Alter

Replace

Number of Signs

Sign Area

Sign Height

Sign Setback

Applicant Information

Principle Contact - First Name

Principle Contact - Last Name

Street Number

Street Name

City/Town

Postal Code

Telephone Number

Email Address

Owner Information

First Name

Last Name

Full Address (including city/town, postal code)

Phone Number

Email Address

Sign Contractor Information

First Name

Last Name

Full Address (including city/town, postal code)

Phone Number

Email Address

Other Requirements

The following plans shall be attached to the complete application:
i. a site plan illustrating the location of the proposed sign(s) on the lot, including setbacks of the sign(s) from all lot lines;
ii. plans of the proposed sign(s) illustrating size, dimensions, sign area, construction, foundation and other a licable details;
iii. other information deemed necessary by the reviewing official, at their sole discretion (i.e., mounting, electrical s ecs, etc.);
iv. an engineer’s report, if required by the reviewing official.
The proposed sign shall comply with Municipality of Thames Centre Sign By-law No. 60-2006, the Ontario Building Code, and provincial and federal acts or regulations.
If the sign is not erected within six (6) months from the date the permit is issued, the sign permit is void.
The Sign Permit Applicant agrees to indemnify and save harmless the Municipality from all actions, causes of actions, suits, claims, demands and costs whatsoever arising by reason of the Applicant, his agents or employees doing, failing to do or doing incorrectly or negligently anything the Applicant is required to do under the terms of a Sign Permit.

I certify that:

The information contained in this application, attached schedules, attached plans and specifications, and other attached documentation is true to be the best of my knowledge.
I have authority to bind the corportation or partnership (if applicable).

Signature

Clear

Date