Driveway Permit Application

I am applying as an:*

Applicant Information

First Name:*

Last Name:*

Mailing Address:*

City:*

Province:*

Postal Code:*

Email:*

Phone Number:*

Owner Information

Are there multiple owners?*

Owner Authorization:*

Upload Owner Authorization.*
A letter from the property owner(s) authorizing the agent to act on their behalf is required. It must be signed by the property owner(s). (PDF format, maximum file size of 1.0MB)

Owner

First Name:*

Last Name:*

Mailing Address:*

City:*

Province:*

Postal Code:*

Email:*

Phone Number:*

Joint Owner

First Name:*

Last Name:*

Email:*

Phone Number:*

Description of Property

Civic Address:*
If no Civic Address, please include the Parcel Identifier (PID) located on the Certificate of Title.

City:*

Province:*

Postal Code:*

Legal Description:*

Application Information

Driveway works you are applying for:*

Is this driveway permit request associated with a building permit?*

Is this driveway permit request for a secondary driveway?*

Site & Building Information

Current Standard of Roadway:*

Width of Proposed Access:*

Please attach a sketch which includes the location of existing (if applicable) and proposed driveway, complete with dimensions for the width of the driveway(s) and distance to at least one property line.*
(PDF format, maximum file size of 9.0MB)
Information we collect and why we collect it.

The City of Courtenay is collecting personal information in accordance with Section 26 (c) of the Freedom of Information and Protection of Privacy Act. The personal information collected in this form (name, contact information, etc.) will be used for the purposes of analyzing  your responses and administering the Driveway Permit Application. Questions about the collection, use, and disclosure of this information can be directed to the City’s Privacy Officer at City Hall, 830 Cliffe Avenue Courtenay, BC V9N 2J7. Phone: 250-334-4441 email: info@courtenay.ca



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