APPLICATION FOR PRIVATE COMMERCIAL SIGNAGE

$75.00
The information on this form is being collected to ensure the sign location specified is in accordance with Regulation 97-143 under the Highway Act. You must complete all mandatory fields and pay the permit application fee of $75 plus HST in order to submit your application.
* Required fields
PART 1 - Signage Information
To be filled in by applicant.
* Route No. or Road Name :
* At     metres      From a Highway Intersection / Exit Number
* Parish of:
* County of :
* Property PID:
* Route:
* Distance from signage to product, service or attraction :   Km
Dimensions of the signage:
* Length:   metres
* Height:   metres
PART 2 - Application Information
Applicant
* Contact Name
Physical Location of Business
* Street/PO Box:
* Municipality:
* Province:
* Postal Code:
Mailing Address
Same Address As Above  
If different:
Street/PO Box:
Municipality:
Province:
Postal Code:
* Phone Number:
* Email Address:
I hereby certify that the above information is correct to the best of my knowledge and belief. Anyone who knowingly makes a false or misleading statement in an application is guilty of an offense.
Click to confirm that you agree with the above statement *
TYPING IN YOUR NAME AND ELECTRONICALLY SENDING THIS FORM CONSTITUTES YOUR ELECTRONIC SIGNATURE.
* Signature * Date (yyyy/mm/dd)
Land Owner
* Contact Name
* Street/PO Box:
* Municipality:
* Province:
* Postal Code:
I hereby certify that I have received permission from the land owner. Anyone who knowingly makes a false or misleading statement in an application is guilty of an offense.
Click to confirm that you agree with the above statement *
TYPING IN YOUR NAME AND ELECTRONICALLY SENDING THIS FORM CONSTITUTES YOUR ELECTRONIC SIGNATURE.
* Signature * Date (yyyy/mm/dd)
Business to be signed
* Contact Name
* Street/PO Box:
* Municipality:
* Province:
* Postal Code:
* Name or description of product, service or attraction being signed:
Sign Manufacturer
* Contact Name
* Street/PO Box:
* Municipality:
* Province:
* Postal Code:
Comments: