Entrance Permit

This form is to request authorization to install a new entrance.

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 

Applicant Information

Contractor Information

Location of Work Information

 Notes:

1. A detailed plan is to be supplied to the Municipality showing the extent and location of work must accompany this application. Area must be marked with grade stakes for staff to inspect in field before permit will be issued.
2. It is the workers responsibility to comply with the Ontario Traffic Manual, Book 7.
3. Owner is responsible for calling locates before commencing work.
4. The Municipality of Thames Centre must approve of the specified contractor assigned to the work.

The applicant agrees to the following terms and conditions noted below:

1. It is the applicant's responsibility to inform Thames Centre when all work is to take place on the road allowance.
2. It is the applicant's responsibility to inform Thames Centre when the work is complete and ready for inspection by Thames Centre's staff.
3. Thames Centre does not guarantee that the location selected for service is not in use by other utilities or services.
4. The applicant will abide by the Occupational Health and Safety Act as set out in Ontario regulation 213-91 and any amendments thereto.
5. The applicant agrees prior to beginning any work on the road allowance to properly set up signage and safety devices which shall be in conformance with the Ontario Traffic Manual, Book 7. Upon completion of work, all signage and safety devices shall be removed. It is the applicant's responsisbility to provide all necessary and signage devices
6. The road allowance shall not be closed at any time. If the road is to be restricted to one lane of traffic the use of properly trained traffic control persons, minimum of two, shall be used to control the flow of traffic.
7. All road crossings are to be completed by boring. The asphalt road surface is not to be cut. All disturbed areas are to be restored to the original condition including any necessary sod, topsoil, and seeding. Damage to sidewalks, road surface, curb and gutter and ditches shall be repaired by the applicant. If the applicant fails to restore any such damage to the satisfaction of Thames Centre, Thames Centre shall use the deposit to restore the damages and any additional costs will be invoiced to the applicant for payment.
8. All material that is backfilled shall be properly compacted to prevent settling. All disturbed areas are to be restored to original conditions.
9. The applicant shall ensure that all utility locates have been obtained. The applicant will be responsible for any utility repairs that are necessary if they are disturbed.
10. The applicant shall ensure that all surface and subsurface drainage is maintained at all times and any damage to drainage works are to be repaired to the satisfaction of Thames Centre.
11. The applicant agrees to hold Thames Centre harmless for any damage or liability caused by work.
12. The applicant shall provide Thames Centre a security deposit before the work may commence along with the original signed copy of this permit.
13. The deposit will be held for 60 days after notification from the applicant that the work has been completed. The work will be inspected by Thames Centre's staff who will determine if the work is completed to the satisfaction of the Municipality before the deposit is returned.

Entrance Specifications:

Proposed culvert to be extended based on graded 2.5(H):1(V) slope maximum from the edge of entrance to the ditch bottom. 150mm of compacted Gran-A must be placed under the culvert. Entrance must have 300mm or more of Gran-A where the entrance meets the road. A rural entrance, at minimum, must be finished with 150mm Gran-A on the surface. Urban entrances must have 150mm of Gran-A and must be hard-surfaced. Each side of the entrance must be top soiled and seeded. All entrances must be compacted to prevent settling.