Fillable Sewage System Verification Guidelines (Township of Oro Medonte)

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Sewage System Verification Guidelines (Township of Oro Medonte)

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Sewage System Verification Guidelines
A Septic Verification Permit shall be submitted where a proposed development will reduce the
performance level. A proper assessment by a Qualified Designer shall be conducted to ensure the
existing sewage system is of adequate size and condition to serve the building appropriately.
Residential Dwelling Unit
In accordance with Ontario Building Code Div B 11.4.2.5 (3), the performance level is
reduced where proposed construction will either:
a) increase the number of bedrooms in the dwelling unit,
b) exceeds 15% of the finished floor area of the dwelling unit, OR
c) adds new plumbing fixtures to the dwelling unit,
And therefore resulting in a total daily design sanitary sewage flow exceeding the capacity of any
component of a sewage system serving the dwelling unit.
Non-Residential
Refer to Ontario Building Code Div B 11.4.2.5 (1)(2) & (4) for effects on performance level.
A complete Septic Verification Application package shall include:
Description
Required
Submission
Status
Comments
Building Permit Application
Schedule 1
Municipal Form 5:
Sewage System Verification
Enclosed
Qualified Designer’s Assessment
(Phase II & Calculations)
Include Use Approval or As-built
drawing to aid Designer with
locating and assessing system.
Concept Plans
Provide floor plans of existing
and proposed (hand drawn is
acceptable for verification only)
Permit Fee $100.00
As per Fees & Charges By-law
NOTE: Any upgrade or replacement of an existing sewage system requires a full sewage permit
INCLUDING the Qualified Designer’s Assessment (Phase II & Calculations)
| Revised July 2020
Application for a Permit to Construct or Demolish – Effective January 1, 2014 Page 1 of 4
Application for a Permit to Construct or Demolish
This form is authorized under subsection 8(1.1) of the Building Code Act,1992
For use by Principal Authority
Application number:
Date received:
Application submitted to:
(Name of municipality, upper-tier municipality, board of health or conservation authority)
A. Project information
Building number, street name
Unit number
Lot/con.
Municipality
Postal code
Plan number/other description
Project value est. $
Area of work (m
2
)
B. Purpose of application
New construction
Addition to an
existing building
Alteration/repair
Demolition
Conditional
Permit
Proposed use of building
Current use of building
Description of proposed work
C. Applicant
Applicant is: Owner or Authorized agent of owner
Last name
First name
Corporation or partnership
Street address
Unit number
Lot/con.
Municipality
Postal code
Province
E-mail
Telephone number
Fax
Cell number
D. Owner (if different from applicant)
Last name
First name
Corporation or partnership
Street address
Unit number
Lot/con.
Municipality
Postal code
Province
E-mail
Telephone number
Fax
Cell number
Application for a Permit to Construct or Demolish – Effective January 1, 2014 Page 2 of 4
E. Builder (optional)
Last name
First name
Corporation or partnership (if applicable)
Street address
Unit number
Lot/con.
Municipality
Postal code
Province
E-mail
Telephone number
Fax
Cell number
F. Tarion Warranty Corporation (Ontario New Home Warranty Program)
i. Is proposed construction for a new home as defined in the Ontario New Home Warranties
Plan Act? If no, go to section G.
Yes
No
ii. Is registration required under the Ontario New Home Warranties Plan Act?
Yes
No
iii. If yes to (ii) provide registration number(s):
G. Required Schedules
i) Attach Schedule 1 for each individual who reviews and takes responsibility for design activities.
ii) Attach Schedule 2 where application is to construct on-site, install or repair a sewage system.
H. Completeness and compliance with applicable law
i) This application meets all the requirements of clauses 1.3.1.3 (5) (a) to (d) of Division C of the
Building Code (the application is made in the correct form and by the owner or authorized agent, all
applicable fields have been completed on the application and required schedules, and all required
schedules are submitted).
Payment has been made of all fees that are required, under the applicable by-law, resolution or
regulation made under clause 7(1)(c) of the Building Code Act, 1992, to be paid when the
application is made.
Yes
Yes
No
No
ii) This application is accompanied by the plans and specifications prescribed by the applicable by-law,
resolution or regulation made under clause 7(1)(b) of the Building Code Act, 1992.
Yes
No
iii) This application is accompanied by the information and documents prescribed by the applicable by-
law, resolution or regulation made under clause 7(1)(b) of the Building Code Act, 1992 which enable
the chief building official to determine whether the proposed building, construction or demolition will
contravene any applicable law.
Yes
No
iv) The proposed building, construction or demolition will not contravene any applicable law.
Yes
No
I. Declaration of applicant
I declare that:
(print name)
1. The information contained in this application, attached schedules, attached plans and specifications, and other attached
documentation is true to the best of my knowledge.
2. If the owner is a corporation or partnership, I have the authority to bind the corporation or partnership.
Date Signature of applicant
Personal information contained in this form and schedules is collected under the authority of subsection 8(1.1) of the Building Code Act, 1992, and will be
used in the administration and enforcement of the Building Code Act, 1992. Questions about the collection of personal information may be addressed to: a)
the Chief Building Official of the municipality or upper-tier municipality to which this application is being made, or, b) the inspector having the powers and
duties of a chief building official in relation to sewage systems or plumbing for an upper-tier municipality, board of health or conservation authority to whom
this application is made, or, c) Director, Building and Development Branch, Ministry of Municipal Affairs and Housing 777 Bay St., 2nd Floor. Toronto, M5G
2E5 (416) 585-6666.
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Application for a Permit to Construct or Demolish – Effective January 1, 2014 Page 3 of 4
Schedule 1: Designer Information
Use one form for each individual who reviews and takes responsibility for design activities with respect to the project.
A. Project Information
Building number, street name
Unit no.
Lot/con.
Municipality
Postal code
Plan number/ other description
B. Individual who reviews and takes responsibility for design activities
Name
Firm
Street address
Unit no.
Lot/con.
Municipality
Postal code
Province
E-mail
Telephone number
Fax number
Cell number
C. Design activities undertaken by individual identified in Section B. [Building Code Table 3.5.2.1. of
Division C]
House
Small Buildings
Large Buildings
Complex Buildings
HVAC – House
Building Services
Detection, Lighting and Power
Fire Protection
Building Structural
Plumbing – House
Plumbing – All Buildings
On-site Sewage Systems
Description of designer’s work
D. Declaration of Designer
I declare that (choose one as appropriate):
(print name)
I review and take responsibility for the design work on behalf of a firm registered under subsection 3.2.4.of Division
C, of the Building Code. I am qualified, and the firm is registered, in the appropriate classes/categories.
Individual BCIN: __________________________________________
Firm BCIN: __________________________________________
I review and take responsibility for the design and am qualified in the appropriate category as an “other designer”
under subsection 3.2.5.of Division C, of the Building Code.
Individual BCIN: __________________________________________
Basis for exemption from registration: ________________________________________________________
The design work is exempt from the registration and qualification requirements of the Building Code.
Basis for exemption from registration and qualification: ___________________________________________
I certify that:
1. The information contained in this schedule is true to the best of my knowledge.
2. I have submitted this application with the knowledge and consent of the firm.
Date Signature of
Designer
NOTE:
1. For the purposes of this form, “individual” means the “person” referred to in Clause 3.2.4.7(1) (c).of Division C, Article 3.2.5.1. of
Division C, and all other persons who are exempt from qualification under Subsections 3.2.4. and 3.2.5. of Division C.
2. Schedule 1 is not required to be completed by a holder of a license, temporary license, or a certificate of practice, issued by the Ontario
Association of Architects. Schedule 1 is also not required to be completed by a holder of a license to practise, a limited license to practise,
or a certificate of authorization, issued by the Association of Professional Engineers of Ontario.
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| Revised Mar 2020
Municipal Form 5: Sewage System Verification
A. Project Information
Building number, street name
Unit no.
Lot/con.
Municipality
Postal code
Plan number/ other description
B. Individual who reviews and takes responsibility for design activities (One form per individual)
Name
Firm
Street address
Unit no.
Lot/con.
Municipality
Postal code
Province
Phone number
E-mail
C. Declaration of Designer
I _____________________________________________________________ declare that the submitted documentation
(print name)
pertaining to the above noted property is in conformance with Part 8 Division B of the Ontario Building Code based on a
site evaluation that;
1. The existing septic system is of adequate size to support the proposed construction based on calculations provided
with this application and proposed floor plans,
2. The sewage system serving the building is in good operating condition and functioning as designed after conducting
a comprehensive evaluation.
I review and take responsibility for the design work on behalf of a firm registered under subsection 3.2.4.of Division
C, of the Building Code. I am qualified, and the firm is registered, in the appropriate classes/categories.
Individual BCIN: ______________________________ Firm BCIN: ________________________________
I review and take responsibility for the design and am qualified in the appropriate category as an “other designer”
under subsection 3.2.5. of Division C, of the Building Code.
Individual BCIN: ______________________________
I certify that:
1. The information contained in this schedule is true to the best of my knowledge.
2. I have submitted this application with the knowledge and consent of the firm.
Date: ___________________________________ Signature:______________________________________________
For the purposes of this form, “individual” means the “person” referred to in Clause 3.2.4.7(1) d).of Division C, Article 3.2.5.1. of Division C
The Township of Oro-Medonte assumes no responsibility regarding the proposed sewage system verification and maintenance/operation of
the sewage system mentioned in this document. It is the sole responsibility of the owner to maintain their sewage system in accordance with
Division B 8.9.3 of the Ontario Building Code.
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Completed 6 April 2021

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