BUILDING DIVISION
LOT SUITABILITY – SEWAGE DISPOSAL SYSTEM
Town/Township: __________________________________
Owner: _____________________________________________________________________________________
Address: _____________________________________________________________________________________
Postal Code: __________________________ Telephone: _____________________________ E-mail: _____________________________
Directions to Lot: ___________________________________________________________________________________
______________________________________
______________________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________________
LOT DIAGRAM AND SEWAGE SYSTEM PLAN:
• Indicate locations of existing/proposed buildings, wells (type), trees, roads and driveway. Proposed location of tank and
tile bed. Physical characteristics of land, ponds, rivers and drainage courses.
• It is the applicant’s responsibility to indicate any drinking water sources within 30 metres (100 ft) of any proposed
sewage system location, including those on adjacent properties.
THE APPLICANT CERTIFIES THAT THE ABOVE INFORMATION AND DETAILS OF THE SITE PLAN ARE CORRECT AND AGREES TO COMPLY
WITH THE REQUIREMENTS OF THE ONTARIO BUILDING CODE AND REGULATIONS AS AMENDED.
Date: ______________________________________ Owner/Agent: ____________________________________________________________________
Square Footage of
Building Finished Area
______m
2
_______ft
2
Dug/Bored Well
Communal
Proposed
Other:
