Hydrant usage permit

Business name

Contact

Address

City

Province

Postal code

Phone number

Water capacity to be taken

average daily m3

I/we will accept responsibility for damage caused on any flusher hydrant as a result of neglect on the part of any person in my/our employ

I/we understand that the water taken from the flusher hydrants with this permit is considered to be non-potable and will not provide this water to or for any person/company for potable purposes.

I/We understand that usage of flusher hydrants must be reported within 24 hours and further acknowledge that this permit authorizes the use of flusher hydrants only.

I/We will notify the Public Works and Physical Services Department of any changes/adjustments.

I/We agree to pay a fee of $250.00 for this application, and the municipality current rate for the quantity of water used (for more than a one time use permit, a deposit of $2000.00 will be required). Fees and deposit will be waived for work done for the municipality.

I/we understand that this constitutes a legal signature confirming that I acknowledge and agree to the above terms.

Signature

Date

Citizen Services

Recreation and Culture

My Municipality

Business

Hydrant usage permit