City of London - Boulevard Cafe Permit Application

Note: Fields marked with ★ are mandatory.

We are committed to providing a fully accessible application process. Please let us know if you require any accommodation: accessibility@london.ca.

Legal name for business

Operating name for business:

City of London Business Licence Number:

Expiry date

Address of restaurant

Restaurant telephone number

Contact Information

Full name of owner:

Owner telephone number:

Name of contact (leave blank, if same as owner):

Contact telephone number (if applicable):

Contact e-mail Address:

Name of corporation, business or partnership of the restaurant:

Business mailing address, including postal code:

Boulevard Cafe Information

Proposed dimensions of boulevard cafe:

Will there be an awning(s) over the cafe?

If you answered yes to the previous quesion, please attach the awning plans

Please attach the sketch and current photograph (see webpage for detailed instructions).

Please attach a copy of City of London Business Licence

Please attach a copy of your third party liability insurance policy

Please attach proof of ownership of property OR written endorsement from the owner of the property

Please attached proof of permission from adjacent land owners, if required

Confirmations

I declare the following:

I have the authority to make this application on behalf of the named applicant and assume responsibility of the application contents and any associated or applicable fees.
I understand and consent to entering into an agreement with the City of London.
I understand and agree to pay an annual fee for the use of the boulevard.
Where permission from adjacent land owners is required, it has been provided.

By submitting this application for consideration, I am declaring that the information in my application is true.

The personal information on this form is collected under the authority of the Municipal Act, 2001 and will be used to assist City of London Realty Services in processing cafe permit applications. Questions about this collection may be referred to the Manager, Realty Services, 300 Dufferin Avenue, London, ON; Tel: 519-661-2489 ext. 5863.

Note: If the form does not appear to submit, please open each section and confirm that there are no issues or missing required fields.