Application for Water 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 water 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-Law 2015-19 and the current year's Fees and Charges By-Law and as may be established from time to time by the Municipality.
2. 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 water service.
3. The Consumer will provide all plumbing on the premises property to the property line and the Ontario Clean Water Agency (OCWA) shall oversee the connection with the Municipality's waterworks. 

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. 236.