Publicized Display Application

This application is required and processed in accordance with Township of Puslinch Bylaw No. 008-2022, pursuant to the Municipal Act, 2001. This application must be approved prior to the assembly of a publicized display on private property. The Applicant is responsible to ensure that an Application is submitted at least sixty (60) days prior to the assembly of a publicized display.

Fill out the form application below or download the printable PDF form.

Name of Applicant *

First

Last

Applicant Email *

Applicant Phone Number *

Address of Applicant *

Address Line 1

Address Line 2

City

OntarioAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonProvince

Postal Code

Address of proposed display *

Address Line 1

Address Line 2

City

OntarioAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonProvince

Postal Code

Description of proposed display *

Proposed dates and times of publicized display *

Describe how you plan on advertising the proposed display *

Please attach a rough sketch/site plan of the publicizes display is required including a map showing the location of the property within the Township, a layout of the display and a location of the display on the property *

Click or drag files to this area to upload. You can upload up to 5 files.

Please attach a document describing the potential traffic impacts *

Click or drag files to this area to upload. You can upload up to 5 files.

Please attach a document detailing the number of expected visitors (based on previous years of operation if applicable) *

Click or drag files to this area to upload. You can upload up to 5 files.

Please attach a waste management plan. *

Click or drag files to this area to upload. You can upload up to 5 files.

Terms and Conditions

I agree that I have reviewed and understand the Township’s Publicized Display By-law 008/2022 and further that I will comply with all requirements set out in that By-law.

The owner will, both during and following the term of the Permit indemnify and save harmless the Township from all costs, losses, damages, judgements, claims, demands, suits, actions, complaints or other proceedings in any manner based upon, occasioned by or attribute to anything done or omitted to be done by the Owner, its directors, officers, employees, agents, sub-contractors or volunteers in connection with the publicized display conducted pursuant to the Permit.

I have read, understood, and will comply to the attached Terms & Conditions which form part of this permit application.

Terms and Conditions *

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

Publicized Display Application Fee

Price: $154.00

Convenience Fee

Price: $2.70

A 1.75% convenience fee is applied to all online payments.

Total

$0.00

Stripe Credit Card *

Card

Name on Card

Signature *

Clear Signature

Submit

Personal information on this form is collected under the authority of the Municipal Act and will be used to determine the eligibility of a permit. The information is used for the purpose of processing this application and administering the entrance permit program and is maintained in accordance with the Municipal Freedom of Information and Protection of Privacy Act. Questions regarding the collection of this information may be directed to the Township Clerk’s office.

The Township of Puslinch is committed to providing accessible formats and communication supports for people with a disability. If another format would work better for you, please contact the Township Clerk’s office for assistance.