Required fields are marked with asterisks (*)

Municipal Consent Application Form

Utility Representative Information

Representative's Company

Representative's Contact First Name

Representative Contact Last Name

Phone

Address

Postal code

Town/City

Contractor Representative Information

Representative Company

Phone

Application Details

Type/Method of Construction

Applicant's File/Job #

Description of work

Location (s)

Proposed start date

Proposed end date

Is the application for a repair?

Yes

Please be advised that as part of the issuance of a Municipal Consent, the applicant is required to verify all property lines and that Haldimand County takes no responsibility for Utility infrastructure installed on private property either purposely or in error. All property must be returned to pre-construction condition.

The review of drawings does not in any way relieve the Engineer or Contractor or Responsible Party for its accuracy, constructability, or for compliance with the contract documents and any governing laws or codes.

Should you require any assistance with your submission, please contact (905) 318-5932 ext 6416 or engineering@haldimandcounty.on.ca