Property
owners are asked to respond to the questions listed below by first putting
information in the spaces provided and then sending it to the 9-1-1 Team
by fax or mail (telephone and address given below).If
you need further clarification as to the meaning of each question, a more
thorough treatment of them is available in a document that can be downloaded
from the website <www.county.haliburton.on.ca>, ordered from the 9-1-1
call center or picked up at your municipal office.
Questions
(1)Record
the assessment roll number printed on your tax bill (19 digits). _________________________________________
(2)Record
the legal property description printed on your tax bill(lot
and concession or subdivision plan no.
____________________________________________________________________________________________________
Contact
Information
(3)What
is your name, permanent address and telephone no:
Name__________________________________________
Address__________________________________________
__________________________________________
Tel.
No. ()____________________________________
E-mail
Address: _________________________________________________________________________
Fax.
No.:()___________________________
Driveway
Information
(4)Is
your building (residence or business) visible just as someone turns in
your driveway? ( Y / N ) Please fill in the following information –
Length
of driveway: ___________________
No
of dwellings off the driveway_________
Hazards
along the driveway_____________________________________________________________________________
Surface
material on driveway _____________________________________________________________________________
Presence
of a gate( Y / N )Circle
oneIs the gate locked when you
are in the building ( Y / N ) Circle one
Access
Road Information
(5)Fill
out the following information about the road with which your driveway
intersects –
Name
(as indicated by a sign or as submitted to 9-1-1) ________________________________________________________
Alternate
Name (in local usage) ___________________________________________________________________________
Road
Maintenance in front of your property(municipal
maintenance/private
maintenance)Circle one
Snowplowing
in front of your property(municipal
snowplowing/private
snowplowing)Circle one
Neighbours
(6)With
your back to your building looking towards the access road, who are your
first neighbours on the left & right on your side and the side opposite?
Your
Side – left __________________________________Other
Side – left______________________________________
right____________________________________right
______________________________________
directly
across ______________________________________
Dwelling
Features and Property Landmarks ( eg
colour, single storey etc)
(7)List
easily recognizable features of your home and of any landmark on
or near the property, and telephone # at property.
Features
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Landmarks
___________________________________________________________________________________________
___________________________________________________________________________________________
Driving
Instructions to get to the Property
(8)Provide
driving instructions to get to your property from your road and the
nearest provincial, county or municipal road.
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Cottage/Road
Association
(9)If
you are a member of a cottage or road association, please answer
the following -
Name
of association (cottage)____________________________________________________________________________
Name
of association(road) ______________________________________________________________________________
Identification
number for your property assigned by the association _______________________________________________
Support
for 9-1-1 Activities
To
complete 9-1-1 work, we need the help of volunteers from the community.The
task is not complicated and takes only a little of your time.
(10)Are
you willing to provide assistance in placing yellow identification markers
on properties?( Yes/No)Circle
one
(11)Are
you willing to act as a representative of your road to assist our effort?
( Yes/No)Circle
one
E-mail:911@
county.haliburton.on.caMinden,
ONK0M 2K0