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Display Form

Sidewalk Patio Application

"*" indicates required fields

Owner or Applicant*

New

Renewal

Renewal with modification

Applicant Name*

First Last

Business Name*

Mailing Address*

Street Address Address Line 2 City Province Postal Code

Phone*

Email*

Owner Name(s) (if different than applicant)*

Sidewalk Patio Municipal Address*

Preferred sidewalk patio install date*

Date of Operation*

Maximum: May 1st to October 31st

Time of Operation*

Number of Parking Spaces Lost*

Seating Capacity*

Number of Proposed Tables*

Adjacent Property Owners Approval (if applicable)*

Yes

On file

AGCO Licensed:*

Approved

Pending Approval

Requirements

Previous Applicant on file for Sidewalk Patio if applicable
If the patio affects parking spaces in addition to directly in front of the applicant's business, written permission from adjacent properties affected by parking space reduction is required
Snow Removal: Owner/Applicant agrees to clear sidewalk in accordance with the City of Brockville's Winter Maintenance Policy
Follow all applicable requirements for Tents, Awning, or Canopies including, but not limited to:

All fabric, textile, or film, as applicable, is required to be certified to CAN/ULC-S109 Flame Tests of Flame-Resistant Fabrics and Films or NFPA 701 Fire Tests for Flame Propagation.
Tents, awnings, and canopies that are intended to be equipped with a fuel fired appliance or heater, as applicable, shall comply with the clearance and ventilation requirements provided by the manufacturer and all applicable standards.
At least two full sides of the outdoor dining area must be open to the outdoors and must not be substantially blocked by any walls or other impermeable physical barriers as per Provincial Legislation.

Sketch showing all dimensions of the sidewalk and all existing and proposed furniture.
Site photos showing the sidewalk and building face where the furniture is proposed to be placed.
Proof of insurance naming the Corporation of the City of Brockville as additional insured (minimum amount $2,000,000)

File Upload*

Drop files here or

Accepted file types: jpg, png, pdf, docx, Max. file size: 300 MB.

Please attach all supporting and required documents as indicated in the section above

Notice with respect to Collection of Personal Information

I agree and acknowledge that the information contained in this application and any documentation, including agreements, reports, studies and drawings, provided in support of the application, by myself, my agents, consultants and solicitors, constitutes public information and will become part of the public record. As such, and in accordance with the provisions of the Municipal Freedom of Information and Protection of Privacy Act, R.S.O. 1990, c. M.56, I hereby consent to the City of Brockville making this application and its supporting documentation available to the general public, including copying and disclosing the application and its supporting documentation to any third party upon their request.

For inquiries regarding your application, please contact: Clerk’s Office 613-342-8772 clerk@brockville.com

Signature of Owner/Applicant*

Date*

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