Road Entrance Permit Application

Road Entrance Permit Application

Complete this form to apply for a new laneway entrance permit. Please fill out all required information as per the original permit structure.
Applicant Information

Please provide your contact details and property location.
Date of Application*

MonthDayYear
Date
Permission is Hereby Granted for:
Full Name*

First NameLast Name
Address*

Street Address

Street Address
CityProvincePostal Code
Telephone Number*
Please enter a valid phone number.Format: (000) 000-0000.
To allow a new laneway entrance installed in front of the property located at:
Lot Number*
Concession Number*
Ward*
Entrance Details

Provide details about the proposed entrance.
Entrance Length*
YesNo
911 Number Cost (CAD)

Cost Legend:

Sign and no post, not installed	$67.00 + $8.71 HST = $75.71
Sign and post, not installed	$79.00 + $10.27 HST = $89.27

This permit is valid for roads controlled by the Township of South-West Oxford ONLY.

I hereby agree to pay the Township of South-West Oxford for the supply and installation of an entrance in 30 days.

Permission is Hereby Granted for: