Required fields are marked with asterisks (*)

Building Permit Payments Form

Permit Number:

Payment Amount ($):

1.75% fee amount:

I acknowledge that I understand and agree to pay the separate 1.75% fee will be charged on top of the total price listed on the payment page:

Yes

First Name

Last Name

Business Name

Email Address (must match the email address used in Citywide account):

Address number (if applicable):

Street Name:

Privacy Statement: Personal Information contained on this form is collected pursuant to the Municipal Freedom of Information and Protection of Privacy Act and will be used for the purpose of issuing and administering a permit. Questions about the collection of this information should be directed to the Manager of Building Services / Chief Building Official, Town of LaSalle, 5950 Malden Road, LaSalle, ON, N9H 1S4. Telephone: 519-969-7770.