Fillable Undertaking Damage to City Property To: The Corporation (City of London, Ontario)

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Undertaking Damage to City Property To: The Corporation (City of London, Ontario)

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Undertaking Damage to City Property
Development & Compliance Division
Phone: 519-930-3510 • E-mail: zoning@london.ca
To: The Corporation of the City of London
Re: Private Swimming Pool and Swimming Pool Fence located at
In consideration of the installation of a private swimming pool and swimming pool fence/enclosure and
issuance of a swimming pool fence permit at the above noted property.
I, ________________________ hereby undertake to repair and replace, to the satisfaction of the City
Engineer, all damage to City property including, without limitation to curbs, sidewalks, and boulevards
sustained directly or indirectly as a result of works undertaken by the Owner under the Permit.
The Owner agrees to indemnify and save harmless the Corporation of the City of London from and against
any and all claims, cost damage or injury to any persons or property arising in any way out of the
performance of this Undertaking.
I, the undersigned, certify that I am the Owner of the address noted above.
Full Name
Company Name (if applicable)
Full Address
E-mail Address
Applicant’s Signature
Date (yyyy-mm-dd)
FOR OFFICE USE ONLY
Permit Number
Phone Number
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Undertaking Damage to City Property To: The Corporation (City of London, Ontario)

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Completed 26 July 2021

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