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Road Occupancy Permit - City of Belleville Application

Please read carefully:

A Road Occupancy Permit relates to any activity that results in traffic disruption, including bins, materials and equipment blocking lanes.

Drawings are to be in compliance with the Ontario Traffic Manual (OTM).

Additional Conditions and Comments

Applicants are responsible for all associated fees, as outlined in the Fees and Charges By-law.
If permit approval for Occupancy is received, the applicant is required to take out a Road Cut Permit if conducting any activity which involves the cutting, excavation, boring, filling, additions, or altering in any way, roadways, curbs, sidewalks, boulevards, ditches, trails, and other areas within the right-of-way

By submitting this form,
I, the undersigned, hereby agree to indemnify and save harmless the Corporation of the City of Belleville from all damages, costs, expenses and liability that they may be put to incur, in defending themselves against claims of damages, or may pay by way of settlement of any such damages by reason of any material or obstruction place on the Municipality property.

Applicant Details

These fields may be automatically populated from a logged-in user's account details

Clear

Organization's Legal Name *

Organization Position/Title

First Name *

Last Name *

Primary Phone Number *

Extension *

Secondary Phone Number

Extension

Email Address *

Address *

City/Town *

Province/State *

Postal/Zip Code *

Fax

Contractor Details

Same as above

Send all Notifications

Organization Name *

Organization Position/Title

First Name *

Last Name *

Primary Phone Number *

Extension *

Secondary Phone Number

Extension

Email Address *

Address *

City/Town *

Province/State *

Postal/Zip Code *

Fax

Drawings

Note: Drawings may also be uploaded as additional attachments below.

Add New Drawing
- No background

Drawing	Preview

Date / Time

Start Date (yyyy-MM-dd) *

End Date (yyyy-MM-dd) *

Location(s)

RIGHT CLICK a point for a location, and multiple points to create a segment. You may turn off the Municipal511 data using the Municipal511 content on/off feature on the map.

Show Municipal 511 Content

The road information displayed is also available at m511.ca

Other Road Jurisdictions	Main Roads	Estimated Price	Conditions

Other Road Jurisdictions	Main Roads	Estimated Price	Conditions

Possible conflicts. Note that events/permits adjacent to the specified location(s) may be listed.

Id	Type	Location	Start Date	End Date

Road Occupancy Permit - City of Belleville Details

Description, location and purpose of work *

What is to be impacted? *

Check all that apply.

Road
Curb
Sidewalk
Boulevard
Ditch
Trail
Entrance
Within 30m of an intersection
Other (specify in Description)

What is the impact to vehicular and bicycle traffic? *

Do roads need to be closed, lanes reduced, detours, unavailability of on-street parking, etc., and when. You may upload traffic management plan below.

What is the impact to pedestrians, cyclists, wheelchairs, etc. on sidewalks, trails and pathways? *

Indicate what sidewalks and paths need to be closed, capacity reduce, detours, etc. and when. You may upload a map for this purpose.

Insurance expiry date

Certificate(s) to be uploaded below.

Applicant reference

This field supports the addition of your internal reference for this application.

File Uploads

Insurance Certificate(s)

Minimum $5 million for public liability.

Drawings and Pictures

Traffic Plan *

Refer to Ontario Traffic Manual, Book 7, Temporary Conditions for traffic plan instructions.

WSIB Certificate

Additional Files

New Permit