Application for Sign Permit

Applicant Information

Name *

Permit to be issued to *

Address *

City / Town: Select... Fort Erie Grimsby Lincoln Niagara Falls Niagara-on-the-Lake Pelham Port Colborne St. Catharines Thorold Wainfleet Welland West Lincoln *

Postal Code *

Contact Information

Name *

Phone Number * xxx-xxx-xxxx  Ext.

Fax Number xxx-xxx-xxxx

Email *

Sign Description

Road Name   Road Number 1 2 3 3A 4 5 7 9 10 12 14 15 18 19 20 21 23 24 25 26 27 28 29 33 34 36 37 38 39 40 41 42 43 45 46 47 48 49 50 54 55 56 57 58 61 63 65 67 68 69 70 71 72 73 77 81 82 83 84 86 87 88 89 89 90 91 98 100 101 102 112 116 122 124 420 512 525 527 529 581 627 669 681

Address of Proposed Sign Location *

City / town: Select... Fort Erie Grimsby Lincoln Niagara Falls Niagara-on-the-Lake Pelham Port Colborne St. Catharines Thorold Wainfleet Welland West Lincoln

Type of Sign Select... Portable Sign Pylon Sign Billboard Fascia Sign Projecting sign Other

Width meters centimeters feet inches       Height meters centimeters feet inches

Ground Clearance meters centimeters feet inches       Overall Height meters centimeters feet inches

Distance from Property Line meters centimeters feet inches

Will the sign be: Illuminated
Electronic/LED Display
Neither

Type of Request Select... New Sign Sign permit Renewal (Portable Signs have a 1 year expiry) Alterations to Existing Sign

Where is the proposed sign going to be located on the property in respect to the street/property line? Please provide a map or sketch of the proposed location and a dimensional drawing of the sign. Email scanned copies to roadpermits@niagararegion.ca specifying the permit type and applicant name in the subject line.

Terms and Conditions

• All applicants must comply with Sign By-law and with applicable requirements of the area municipality in which the sign is located as well as other applicable provincial or federal statute or regulation. Issuance of a regional permit does not in any way relieve the applicant from the requirement to obtain such area municipality or other permits.
• Plot plans and/or dimensional drawing must accompany this application
• Applicant to ensure that the entire sign is placed on private property

Personal Information and Privacy

Any personal information or personal health information submitted in writing will be collected, used and disclosed by members of Regional Council and Regional staff in accordance with the Municipal Freedom of Information and Protection of Privacy Act or the Personal Health Information Protection Act, where applicable.

Any information you share will be used only for the intended purpose for which it was provided. If you have any questions, email our Access and Privacy Office or call 905-980-6000 ext. 3779.