Required fields are marked with asterisks (*)

Closed sign request

The Region of Waterloo is offering signs* - free of charge - to display at areas your business is closing for the winter season. Closing areas not required during the winter can reduce slip and fall risks, protect your business from salt damage and protect our community's drinking water.

Once the form is submitted, Region of Waterloo staff will be in contact to confirm the order and provide an estimated time of delivery.

*Available while supplies last, the Region of Waterloo has the right to limit quantity provided. Property must be located in Waterloo Region. Upon receipt of the sign your organization agrees to display at a closed section of your property to reduce salting during the winter season.

Specifications:

Sign size: 30cm wide x 45cm high (12 inches wide x 18 inches high)
Sign material: aluminum steel
Weight: 0.5 kg (1.1 lbs)
Display options: hang from chains, mount on post or attach to fence (not included with sign - hardware required to display the sign is the responsibility of the property owner)

closed sign

I agree to display the Area Closed sign this winter and confirm:

The property is located in Waterloo Region

The area(s) on the property to close have already been identified

Approvals required to close area(s) have been obtained (such as from property owner, management)

Winter maintenance plan is updated to include area(s) to close

Resources in place to close area(s)

What is the main reason for closing areas? (select only one response)

Supports Source Water Protection risk management plan

Allows winter maintenance team to focus efforts on high traffic areas

Reduce winter maintenance costs and repairs from salt damage

Manage risk from potential slip and fall hazards

Reduce winter maintenance costs from plowing and salting

Provides location to store plowed snow

Other

If other selected, include details here:

Property information

Location of where the Area Closed sign will be displayed.

Name of organization

Address

City/ Town

Postal code

Areas to close (select all that apply):

parking

patio

stairs

walkway

other

If other selected, include details here:

Number of signs required:

Approximate size of area to close (square metres):

Delivery details (address to drop off signs, hours open, phone number to call upon arrival or other information required to deliver sign)

Contact information

First Name

Last Name

Daytime Phone Number

Phone extension

Email Address

If other selected, include details here

Can Region of Waterloo staff follow up to request feedback on program and take photos of closed areas?

Yes

Comments and/or additional information

Notice of Collection of Personal Information

To the extent that the foregoing information constitutes personal information as defined in the Municipal Freedom of Information and Protection of Privacy Act, R.S.O. 1990, chapter M.56 as amended, the information is subject to provisions of that Act and will be used to collect information for the purpose of distributing requested materials. Questions about the collection of personal information should be directed to Region of Waterloo Water and Wastewater Services, waterservices@regionofwaterloo.ca or 519-575-4400.

I have read and understood the above notice of collection of my personal information.

Yes

Region of Waterloo Form

Closed sign request

Specifications:

Property information

Contact information

Notice of Collection of Personal Information