Sign Permit Requirement Checklist

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1 Requirements for a Fascia or Ground Permit: Completed application form to construct or demolish Completed sign permit details form Letter of authorization from property owner Permit fee (refer to fee schedule below) Permit Requirement Checklist Completed site alteration permit screening application form (ground signs only) Two copies of a survey or site plan which include: Lot lines Existing building locations Linear frontage of the unit (fascia signs only) Setbacks of the sign from property line and the street Location of easements (ground signs only) Two copies of detailed construction drawings which include: Dimensions of sign(s) in metric Elevations showing location of sign(s) on the building and projection of sign on the building Stamp and signature from an Engineer, Architect or designer with a BCIN qualified in structural design Fee Schedule: Up to 2.5 sq. m. $ sq. m. To 8.0 sq. m. $ Over 8 sq. m. $ Billboard $ It is the responsibility of the applicant to contact the following agencies to determine if approvals are required. Building Department (905) (if property is on a septic system) Burlington Hydro (905) after Hours (905) Conservation Halton (905) MTO (If property is within 400m of any limit of a provincial Hwy) Niagara Escarpment Commission (905) Ontario One Call (Locates for Bell Canada, Union Gas, Cable, Hydro) Parkway Belt Trans Canada (for Trans Canada Pipeline easements)

2 Application for a Permit to Construct or Demolish This form is authorized under subsection 8(1.1) of the Building Code Act,1992 Application number: For use by Principal Authority Permit number (if different): Date received: Roll number: Application submitted to: (Name of municipality, upper-tier municipality, board of health or conservation authority) A. Project information Building number, street name Unit number Lot/con. Municipality Postal code Plan number/other description Project value est. $ Area of work (m 2 ) B. Purpose of application New construction Addition to an Alteration/repair Demolition Conditional existing building Permit Proposed use of building Current use of building Description of proposed work C. Applicant Applicant is: Owner or Authorized agent of owner Last name First name Corporation or partnership Street address Unit number Lot/con. Municipality Postal code Province Telephone number Fax Cell number D. Owner (if different from applicant) Last name First name Corporation or partnership Street address Unit number Lot/con. Municipality Postal code Province Telephone number Fax Cell number Application for a Permit to Construct or Demolish Effective January 1, 2014

3 E. Builder (optional) Last name First name Corporation or partnership (if applicable) Street address Unit number Lot/con. Municipality Postal code Province Telephone number Fax Cell number F. Tarion Warranty Corporation (Ontario New Home Warranty Program) i. Is proposed construction for a new home as defined in the Ontario New Home Warranties Plan Act? If no, go to section G. ii. Is registration required under the Ontario New Home Warranties Plan Act? iii. If yes to (ii) provide registration number(s): G. Required Schedules i) Attach Schedule 1 for each individual who reviews and takes responsibility for design activities. ii) Attach Schedule 2 where application is to construct on-site, install or repair a sewage system. H. Completeness and compliance with applicable law i) This application meets all the requirements of clauses (5) (a) to (d) of Division C of the Building Code (the application is made in the correct form and by the owner or authorized agent, all applicable fields have been completed on the application and required schedules, and all required schedules are submitted). Payment has been made of all fees that are required, under the applicable by-law, resolution or regulation made under clause 7(1)(c) of the Building Code Act, 1992, to be paid when the application is made. ii) This application is accompanied by the plans and specifications prescribed by the applicable by-law, resolution or regulation made under clause 7(1)(b) of the Building Code Act, iii) This application is accompanied by the information and documents prescribed by the applicable bylaw, resolution or regulation made under clause 7(1)(b) of the Building Code Act, 1992 which enable the chief building official to determine whether the proposed building, construction or demolition will contravene any applicable law. iv) The proposed building, construction or demolition will not contravene any applicable law. I. Declaration of applicant I (print name) declare that: 1. The information contained in this application, attached schedules, attached plans and specifications, and other attached documentation is true to the best of my knowledge. 2. If the owner is a corporation or partnership, I have the authority to bind the corporation or partnership. Date ature of applicant Personal information contained in this form and schedules is collected under the authority of subsection 8(1.1) of the Building Code Act, 1992, and will be used in the administration and enforcement of the Building Code Act, Questions about the collection of personal information may be addressed to: a) the Chief Building Official of the municipality or upper-tier municipality to which this application is being made, or, b) the inspector having the powers and duties of a chief building official in relation to sewage systems or plumbing for an upper-tier municipality, board of health or conservation authority to whom this application is made, or, c) Director, Building and Development Branch, Ministry of Municipal Affairs and Housing 777 Bay St., 2nd Floor. Toronto, M5G 2E5 (416) Application for a Permit to Construct or Demolish Effective January 1, 2014

4 SIGN PERMIT DETAILS ALL MEASUREMENTS ARE TO BE IN METRIC NOTE: Two complete sets of Stamped detailed drawings are to be submitted with this application, showing details of construction of the sign(s), details of all supports, braces, anchorage and: Site plan showing lot lines and existing building locations for ALL signs Site alteration permit screening information form completed & signed for all ground signs OFFICE USE Permit No: Fascia s / Ground s Total Permit Fee: / Receipt No: Payment Method: Total Fascia m 2 Total Ground m 2 Zoning Variance Y or N Easements Y or N Septic System Y or N Permit No: SIGN #1 Tenant Wording on Contact Name Phone Fascia Box Fascia Banner Fascia Canopy Fascia Individual Letters Ground Billboard (Fascia s : location on the building) (Ground s: location on the property) Illumination: Internal External None Height of : m (Fascia & Ground s - From grade level to top of the sign) Permit No: SIGN #2 Tenant Wording on Contact Name Phone Fascia Box Fascia Banner Fascia Canopy Fascia Individual Letters Ground Billboard (Fascia s : location on the building) (Ground s: location on the property) Illumination: Internal External None Height of : m (Fascia & Ground s - From grade level to top of the sign) Permit No: SIGN #3 Tenant Wording on Contact Name Phone Fascia Box Fascia Banner Fascia Canopy Fascia Individual Letters Ground Billboard (Fascia s : location on the building) (Ground s: location on the property) Illumination: Internal External None Height of : m (Fascia & Ground s - From grade level to top of the sign) When Your Permit Is Issued & Ready for Pick Up : Phone or Owner Contractor Applicant APPLICANTS DECLARATION I, understand that any applicable law such as the City s by-law & Zoning by-law must be reviewed and in compliance prior to the issuance of a permit. Date: ature

5 Permit No: SIGN #4 Tenant Wording on Contact Name Phone Fascia Box Fascia Banner Fascia Canopy Fascia Individual Letters Ground Billboard (Fascia s : location on the building) (Ground s: location on the property) Illumination: Internal External None Height of : m (Fascia & Ground s - From grade level to top of the sign) Permit No: SIGN #5 Tenant Wording on Contact Name Phone Fascia Box Fascia Banner Fascia Canopy Fascia Individual Letters Ground Billboard (Fascia s : location on the building) (Ground s: location on the property) Illumination: Internal External None Height of : m (Fascia & Ground s - From grade level to top of the sign) Permit No: SIGN #6 Tenant Wording on Contact Name Phone Fascia Box Fascia Banner Fascia Canopy Fascia Individual Letters Ground Billboard (Fascia s : location on the building) (Ground s: location on the property) Illumination: Internal External None Height of : m (Fascia & Ground s - From grade level to top of the sign) Permit No: SIGN #7 Tenant Wording on Contact Name Phone Fascia Box Fascia Banner Fascia Canopy Fascia Individual Letters Ground Billboard (Fascia s : location on the building) (Ground s: location on the property) Illumination: Internal External None Height of : m (Fascia & Ground s - From grade level to top of the sign) Permit No: SIGN #8 Tenant Wording on Contact Name Phone Fascia Box Fascia Banner Fascia Canopy Fascia Individual Letters Ground Billboard (Fascia s : location on the building) (Ground s: location on the property) Illumination: Internal External None Height of : m (Fascia & Ground s - From grade level to top of the sign)

6 SITE ALTERATION PERMIT SCREENING INFORMATION THIS APPLICATION IS AUTHORIZED BY BY-LAW No NAME: ADDRESS: Depending on the type of works you are proposing on your property, you may need a Site Alteration Permit prior to construction to ensure that you, your neighbours and/or the environment are not negatively impacted. Site Alteration Permits are administered by the Capital Works Department to ensure that the Director is satisfied that works on private property will not result in: a) Adverse erosion effects on and off-site; b) Blockage of a swale, ditch, watercourse, etc.; c) Transportation of silt into a watercourse, wetland, or storm sewer, etc.; d) Transportation of silt to adjacent, neighbouring or downstream properties; e) Pollution of a watercourse; f) Flooding or ponding on adjacent properties; g) Flooding or ponding caused by a watercourse overflowing its banks; h) Hindering the orderly development of any lands; i) Detrimental effect on the quality or quantity of water in wells; j) Detrimental effect on any trees of a calliper of 75mm or more located on the lands; k) Detrimental effect on matters of inherent sensitivity such as, but not limited to aquifer recharge, soil permeability, water quality and wildlife habitat; l) Unauthorized injury or destruction of municipal trees or other trees protected under By-laws of the City of Burlington or Halton Region; m) Injury or destruction of other trees, which in the opinion of the Director, could reasonably be avoided; n) A loss of agricultural land in the Rural Planning Areas as defined in Schedule C of the City of Burlington Official Plan; o) Detrimental effects on the natural environment, including but not restricted to lands designated as Lake Ontario shoreline, Burlington Bay / Hamilton Harbour Shoreline, Niagara Escarpment and Areas of Natural or Scientific Interest and habitat of endangered or threatened species as identified and defined by the Ministry of Natural Resources (MNR); p) Detrimental effect within 120 metres of a Provincially ificant Wetland identified by the Ministry of Natural Resources and wetlands regulated under Ontario Regulation 162/06; q) Detrimental effects to the growth and/or harvest of fruit, vegetables or other crops, landscaping and gardens; r) Detrimental effects to natural site lines of adjacent properties; s) Detrimental effects to areas of archaeological significance; and t) Contamination of, or the degradation of the environmental quality of the land. Please answer the following question with respect to the proposed works. If you respond Yes to one or more questions, please contact the Capital Works Department (2 nd Floor, City Hall) since the proposed works likely require a Site Alteration Permit Contact the Capital Works Department should your proposed works require changes contact Capital Works Department prior to construction. 1

7 Site Alteration Permits are regulated by the City of Burlington under By-law Non-compliance with By-Law may result in penalties. YES NO Are you proposing to alter the grade on your property? If YES, are you proposing to alter the grade within 0.5m of any property line? Are you proposing to place fill that has a lower permeability than the existing underlying native soil on the receiving site? Are you proposing to install a retaining wall on your property? Are you proposing to remove topsoil on a site greater than 0.2 ha (0.5 acres) in area (approximate dimensions of 20m x 100m)? Are you proposing to remove vegetation cover on a site greater than 0.2 ha (0.5 acres) in area? Are you proposing to alter the grade on a property that is next to a watercourse, wetland, pond, Lake Ontario or Burlington Bay / Hamilton Harbour? Are you proposing to construct a pond in the Rural Planning Area of the City? Are you proposing to construct a residence, garage, agricultural building or other structure in the Rural Planning Area of the City? Date ature of Owner / Applicant OFFICE USE ONLY YES NO Is Site Alteration Permit Exempt? If YES, provide justification. Date Approved By: 2

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