Norfolk County Accessible Street Signage Application

Accessible Street Signs are intended to warn drivers they are approaching an area in Norfolk County where a person living with a disability resides. Additional caution should be given when traveling through these areas.

"*" indicates required fields

Name*

First Last

Address*

Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code

Phone*

Email*

Sign is intended for:*

Applicant

Individual under the primary care of applicant

Other

Other*

Does the person(s) the sign is intended for reside at the above address:*

Yes

No

Please identify their permanent address

Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code

Does the person the sign is intended for identify as living with one or more of the following disabilities:

Deafness/persons with hearing loss

Blindness/persons with vision loss

Autism

Additional Comments

1. The location of the sign(s) will be determined through a site review. Generally one sign will be installed per direction, about 100 metres in advance of the address
2. You are required to contact the Accessibility and Special Projects Department if there are any changes that would require the signs to be changed or removed, such as a change in address etc.
3. Accessibility and Special Projects Staff will contact you either by phone or email on an annual basis to verify that the sign is still required for the person(s) residing at the above noted address. If we do not receive a response from you, we will mail or hand deliver a letter to the applicants address as a final notice. The sign(s) will be removed if an acknowledgement is not received within 30 days of the date of the letter
4. Please be advised that the sign has no legal status under the Ontario Highway Traffic Act. By signing and submitting this application, you acknowledge that the sign is informational only and is not to be construed as a device to protect persons from vehicular traffic
5. Upon a complete application, please allow 6 weeks for the signs to be installed

Signature