Application for Sewer Service Connection Permit

For the provision of water service:

1. I, undersigned, (hereinafter called the "Consumer") do hereby request the Municipality to make necessary connection(2) and provide sewage service at the premises listed below and I undertake and agree to be bound by the rules and regulations and general conditions as stated herein and in By-Laws 2009-06 and 2010-53 and the current year's Fees and Charges By-Law and as may be established from time to time by the Municipality.
2. This agreement shall not be binding upon the Municipality until accepted by it through its proper officers, and shall not be modified or affected by any promise, agreement or representation, by any agent or employee of the Municipality, unless incorporated in writing into this agreement before such acceptance.
3. The Consumer vacating the below listed premises without notifying the Municipality is liable for all subsequent accounts until a new consumer is registered at the vacated location. It is the Consumer's responsibility and in his/her best interest to advise the Municipality in writing when he/she vacates the premises where he/she was registered for sewer service.
4. The Consumer agrees that on request of the Municipality at its direction, he/she will make a deposit to be held by the Municipality without interest as a guarantee that the Consumer will fulfill all the terms of this agreement.
5. The Consumer will provide all plumbing on the premises up to the point of connection with the Municipality's sewage works and maintain the same in efficient condition with proper devices.
6. The rates charged for sewage service are subject to the Municipality's Fees and Charges By-Law for the current year. 
7. This agreement shall continue in force from year to year until terminated by a notice in writing, given by either party hereto at least one month before the end of the term or any year term thereafter.
8. The Consumer agrees not to make any changes in or additions to his/her plumbing or connecting the sewer line after the same has been installed by the Consumer and inspected by the Municipality except with the written consent of the Municipality.
9. It is agreed that the signatures of the parties hereto shall be binding upon their successors or assigns, and that the vacating of the premises herein named shall not release the Consumer from this agreement, except at the option and by written consent of the Municipality. 

Connection Fee

$3,000.00 payable to the Municipality of Northern Bruce Peninsula.

Permit Application will not be processed until such time as payment has been received. 

For Office use only:

The personal information collected on this form is collected under the authority of the Municipal Act and will be used by the Municipality of Northern Bruce Peninsula for the purpose of responding to your application. Questions regarding the collection of personal information should be addressed to the Municipal Clerk at 56 Lindsay Road 5, Lion's Head, ON  N0H 1W0 or by telephone at (519) 793-3522 ext. 229.