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On Street Patio Application Form

Please complete this form, attach all required information.

 

APPLICANT INFORMATION

PROPERTY OWNER INFORMATION
If applicant is property owner, please proceed to next section.

Every application for an On-Street Patio permit shall:

  • be submitted annually in the form prescribed by the Clerk at least 30 days prior to the intended installation date (completing this application form);
  • be accompanied by the required administration fee as per the current Municipality of Kincardine Rates and Fees By-law;
  • be accompanied by a photograph of the intended site location (attach below);
  • be accompanied by proof of insurance as described in Section 9 of By-law No. 2021 - 069 (attach below);
  • be accompanied by an On-Street Patio Site Plan in accordance with the provisions of Schedule “A” of By-law No. 2021 - 069;
  • be accompanied by a completed Accessibility Checklist, Schedule “B” of By-law No. 2021 - 069 (attach below);
  • be signed by the applicant who shall certify as to the truth of the contents of the application;
  • be accompanied by any documentation required in section 4.1 of By-law No. 2021 - 069 (attach any related documentation below).
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I, the undersigned, am authorized owner/agent to sign the above application and I certify the truth of all the statements or representations contained therein. 

I also hereby acknowledge that I have received a copy of the Municipality’s On-Street Patio By-law and have read and understood the provisions of said Policy. 

I acknowledge that in the event permission is granted to me erect an On-street Patio, any non-compliance with specific By-law provisions and/or conditions, plan, specifications, etc. proposed in the above application is prohibited and such could result in my permission being revoked. 

I further acknowledge that in the event that permission is revoked for any cause or irregularity or non-conformity with the By-law or requirements of the Municipality, there shall be no right of claim whatsoever against the municipal corporation or any official, employee or agent thereof and any such claim is hereby expressly waived. 

 

Personal information collected under the authority of the Municipal Act, 2001, S.O. 2001 c. 25 and will be used for the purpose of creating a record to determine eligibility for a municipal On-Street Patio Permit.  This information may be forwarded to various Municipal Departments and Agencies for comment.  Questions about this collection should be addressed to the Clerk of the Municipality of Kincardine at 1475 Concession 5, RR #5, Kincardine ON N2Z 2X6, 519-396-3468



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