Hydrant Use Permit Application

Applicant

Applicant Full Name

Company Name

Address

Unit

City

Postal Code

Phone number

Project Information

Please review the Hydrant Map information.

Address/Location

Hydrant #

Preferred Start Date for Use

Preferred End Date for Use

Site Supervisor

Phone Number

Purpose of Work

Are you performing capital work on behalf of the City of New Westminster

Yes

Backflow Assembly Information

Manufacture

Serial number

Test Performed By

Certification #

Tester Company Name

Phone Number

Tester Company Address

Please attach proof of Backflow Assembly testing certification:

Conditions of Use

The City will not supply or install a backflow prevention assembly. Independent hydrant port is NOT to be used by the Permit Holder.
Valid for use during permitted hours - "Permitted Hours" means the time periods between 7:00 a.m. and 8:00 p.m. on weekdays and between 9:00 a.m. and 6:00 p.m. on Saturdays, but does not include Sundays or other holidays. (Construction Noise Bylaw, 6063)
If you wish to cancel this permit, please call 604-526-4691 prior to the day permit is issued for, otherwise charges will apply.
$1088.00 Damage Deposit is required for all Hydrant Use Permits. Notify engops@newwestcity.ca upon completion of this project and your deposit will be refunded pending an inspection of the hydrant and site.
Application fee for Hydrant Use is $560. Additional fees may apply for water usage.
The holder of this permit is responsible for all damage to equipment and property that may occur and indemnifies the City against any and all claims associated with the use of the hydrant(s). The holder is cautioned that the City water supply is chlorinated and discharge of water must be controlled and treated so as not be detrimental to the natural environment. (Erosion and Sediment Control Bylaw, 7754)
Hydrants must not be charged during off work hours. Failure to do so will result in the permanent collection of the Damage Deposit.
This permit is only valid for the dates and locations stated, is not transferable and is subject to cancellation without notice. The hydrant will be available for use within 48 hours of issuance of this permit.

Acknowledgement

I confirm that all information I have provided is true and accurate to the best of my knowledge. I have read and understood the requirements for this permit and agree to the terms and conditions as stated on the Hydrant Use Permit Application. If I have any questions or concerns I will contact the issuing department, Public Works, at 604-526-4691 or engops@newwestcity.ca.

I acknowledge that the City reserves the right to amend or vary a Hydrant Use Permit at any time, suspend or revoke the permit for reasons of public safety, or if permit holder fails to comply with the terms and conditions of the Permit.

The City of New Westminster is committed to protecting your privacy. This information is collected by the City of New Westminster under Section 26(c) of the Freedom of Information and Protection of Privacy Act and will be used for the purpose of administering the Hydrant Use Permit online application service to you. Should you have any questions about the collection of this personal information please contact the FOI and Privacy Coordinator, 511 Royal Avenue, New Westminster, V3L 1H9, 604-527-4523, privacy@newwestcity.ca.