Building Permit Owner Authorization Download the printable PDF form Please enable JavaScript in your browser to complete this form.A. Property Owner InformationName of First Owner *FirstLastEmail Address of First Owner *All correspondence, notices, etc., in respect of this application, will be forwarded to the applicant. You will receive a copy of this authorization by email.Name of Second OwnerFirstLastB. Property InformationLegal Description *Civic Address of Property *Address Line 1Address Line 2CityAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonProvincePostal CodeTax Assessment Roll Number *C. Agent to be AuthorizedName of Agent *FirstLastThe agent is anyone who is applying for a building permit on behalf of the owner. For example; builder, contractor etc. Email Address of Agent *All correspondence related to this application will be forwarded to this email address.Construction Description *Please provide a description of the proposed construction for which the agent is seeking authorization.D. Owner's AuthorizationI/We am/are the registered owner(s) of the above noted property that is the subject of this application. *YesNoName of First Registered Owner *FirstLastI authorize the Agent named in Section C of this form to make application on my behalf to the Township of Puslinch for a building permit to authorize the construction described in Section C on the above-noted property. *Clear SignatureSignature of First Registered OwnerName of Second Registered OwnerFirstLastI authorize the Agent named in Section C of this form to make application on my behalf to the Township of Puslinch for a building permit to authorize the construction described in Section C on the above-noted property.Clear SignatureSignature of Second Registered OwnerPersonal information on this form is collected under the authority of the Building Code Act. The information is used for the purpose of processing this application and administering the building 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. *I have read and acknowledge this informationEmailSubmit
