Haul Route Permit - Township of Puslinch

Property Owner's Name *

First

Last

Property Owner's Phone Number *

Property Owner's Email Address *

Property Roll Number

Example 23-01-000-000-00000-0000

Property Address *

Address Line 1

Address Line 2

City

Province

Postal Code

Attach front and back of government issued identification with property address (property owner). *

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Are you submitting this application on behalf of the property owner? *

Yes
No

Name of Agent *

First

Last

Agent's Address *

Address Line 1

Address Line 2

City

Province

Postal Code

Agent's Phone Number *

Agent's Email Address *

Attach front and back of government issued identification with property address (agent) *

Click or drag files to this area to upload. You can upload up to 3 files.

Complaint Protocol Contact

The Applicant shall provide the Township with a 24/7 accessible phone number where Township staff can directly reach the Applicant to address any Highway activity concerns.

Please identify the complaint protocol contact. This must match the owner/agent information provided above. *

Owner
Agent

Application Requirements

Please identify if this application is related to any of the following:

Site Alternation Permit Application exceeding 20 cubric metres
Building Permit Application
Aggregate Pit Operation
Development Agreement (approved site plan control agreement, subdivision, condominium, site servicing etc.)

What is the volume of Fill being imported from off-site in cubic metres? *

Please attach a map of the proposed Haul Route indicating any barricades or signs. *

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Please attach a copy of your Site Alteration Application Inquiry Form / Permit Application. *

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Please provide proof of insurance in accordance with Section 16 of the Road Activity By-law. *

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The Applicant shall maintain liability insurance in the minimum amount of $5,000,000, naming the Township as an additional insured. Such policy shall include a cross-liability provision and 30 days’ written notice to the Township prior to cancellation.

Please provide a schedule of hours of operation for hauling or road activity. *

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In accordance with Section 18(b.) of the Road Activity By-law Highway activity associated with a Haul Route Permit shall only occur during the hours of 8:30am to 5:00pm Monday-Friday excluding weekends and statutory holidays.

.

I understand that the property owner is applicable of all fees.

I understand that, the Permit Holder shall comply with all Applicable Laws.

I understand that, highway activity associated with a Hall Route permit shall only occurring during the hours of 8:30 a.m. to 5:00 p.m. Monday – Friday excluding weekends and statutory holidays.

I understand that, the approved Haul Route shall at all times be maintained by the Permit Holder in a dust/silt/mud/rock free condition, to the satisfaction of the Director of Public Works.

I understand that, the Permit Holder shall ensure that a street-sweeper or equivalent is utilized on a daily basis to clean the Haul Route of any tracked debris and shall regularly monitor for any larger foreign objects. The Permit Holder shall be required to maintain the Haul Route in a good state of repair, free from ruts/potholes, etc., to the satisfaction of the Director of Public Works. The Permit Holder shall be responsible for the cost associated to undertake such repairs/maintenance as the Director of Public Works may direct, within such time frame as the Township may specify, acting reasonably.

I understand that, the Applicant shall provide the Township with a 24/7 accessible phone number where Township staff can directly reach the Applicant to address any Highway activity concerns. I understand that The Applicant shall provide the Township with securities in the amount to be determined by the Director of Public Works, in the form of cash or an irrevocable Letter of Credit on terms satisfactory to the Township. Please note that this permit does not apply during half load season (March 15 – April 30).

I have read, understood and agree to the Terms and Conditions.

Signature

Clear Signature