Required fields are marked with asterisks (*)

Application for assisted sidewalk and windrow snow clearing services

This application form is for sidewalk and windrow snow clearing services for eligible seniors and persons with a disability. Please read this application information carefully.

If your application was successful in previous winter seasons, you do not need to re-apply. Staff will be in contact to enroll you in the program for the coming winter season and beyond.

Applications are considered for the upcoming winter season between August 1 and September 15.

Any applications received outside of these dates will be considered for the next season’s service delivery.

Who qualifies?

Must be age 65 years or older.
OR
Have a disability which prevents snow removal.
And
Must be a Kitchener resident.
Reside in a single family, semi-detached or duplex dwelling unit and be owner or renter of such property.
Have no person living in the same dwelling unit who is physically capable of snow removal.
The total gross household income for all people living on the premises aged 18 or over must not exceed $46,000.
Agree to a waiver of claims against the City with respect to any property or other damage which might arise out of the services being provided.

The program provides snow removal services for eligible seniors and persons with a disability. This service starts following a snowfall of more than 2.5 cm (1”) and consists of snow removal from city sidewalks fronting onto houses, sidewalks beside corner lots and driveway windrows (i.e. the pile of snow at the bottom of the driveway that is left after a snow plow clears the street).

This service does not include driveways or any walkways leading to the entrance of the home.

To apply for this program, complete and sign the application form attached. Successful applicants will be notified by email and/or phone. Applicants are reminded that meeting all the eligibility criteria does not guarantee a spot in this program as there are limited spaces available.

Applicants are reminded that if their application is approved they will be automatically enrolled into the future years of the program and do not need to re-apply again.

For more information, call 519-741-2345.

Contact information and address of residence:

First name

Last name

Street address

Unit

Postal code

Phone number

Email address

Household income:

To be eligible for the program the total gross income of all people living on the premises aged 18 or over must not exceed $46,000. Please complete the following:

Total household income:

Household occupants:

Total number of household occupants:

Occupants between age of 0 and 17 years

Occupants age 18 years or older

Please select the boxes that apply:

Occupant of a single family, semi-detached or duplex dwelling unit.

Over age 65.

Has a physical disability which prevents snow removal.

No relatives under age of 65 reside at this property.

Relatives under age 65 residing at this address have a physical disability. Their health would be endangered by removing snow from the sidewalk.

Acknowledgement of understanding:

I understand that the Assisted Sidewalk and Windrow Snow Clearing Services work as follows:

Applications are considered for the upcoming winter season between August 1 and September 15. Any applications received outside of these dates will be considered for the next season’s service delivery.

The contractor has 24 hours after the snow event has stopped to arrive at your property.

The contractor will remove snow and ice from windrow and sidewalk fronting onto properties, sidewalk beside corner lots and driveway windrows.

I am responsible for keeping the sidewalk and windrow areas free of obstructions at all times.

I understand and acknowledge the following:

The city reserves the right to require proof documentation as deemed necessary by city staff. Proof documents are listed in the Proof Documents section on below.

Fraudulent applications shall be subject to fees and charges associated to the actual cost of service.

I confirm that the address I have requested snow removal services for is not a condominium dwelling whereby all snow removal is the direct responsibility of the condominium corporation.

I hereby waive any and all rights of claim against the Corporation of the City of Kitchener and/or against officials, employees, agents, organizations and/or individuals hired on a contract basis by or with the said City of Kitchener, for property damages, which may arise from my being provided with the assisted sidewalk and windrow snow clearing services that I am requesting.

I declare that I have read and understand the information included on this application.

I declare that information to be a true and accurate statement and that I will notify the City of Kitchener if any conditions change.

Would you like to participate in a survey to evaluate the effectiveness of the program?

I am providing my consent to receive a survey conducted by the city staff to evaluate the effectiveness of the program. Participation in the survey is optional.

Personal information is being collected under the authority of s. 28(2) of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA) and will be used to review applications for the application for assisted Sidewalk and Windrow Snow Clearing Services program. This information will be shared with staff who require it for their work as part of reviewing applications and will be stored on a server owned by a Third Party Service Provider (eSolutions Group) located in Canada. The personal information collected herein will be used only for the purposes relating to the program and will be protected in accordance with the requirements stipulated in the MFIPPA.

Inquiries about the collection, use or disclosure of your personal information should be directed to snowclearingassistance@kitchener.ca

Proof documents:

The following type of documents may be requested by the City (but do not need to be included at this time).

Proof of age documents may be:

Senior citizen card
Birth certificate
Passport
Driver’s license

Proof of disability documents may be:

Accessible Parking Permit issued by the Ontario Ministry of Transportation (M.T.O.)
Canadian Pension Plan (C.P.P.) Disability Benefit Card
Canadian National Institute for the Blind (C.N.I.B) Client Card
Disability Travel Card
Ontario Disability Support Program (O.D.S.P) Receipt
Medical proof from a Canadian Regulated Health Practitioner

Proof of total gross income may be:

Notice of Assessment(s) from Revenue Canada for the preceding taxation year for all people living on the property.

If you require this document in an alternative format, please call 519-741-2345.

Form Builder

Application for assisted sidewalk and windrow snow clearing services

Who qualifies?

Contact information and address of residence:

Household income:

Household occupants:

Acknowledgement of understanding:

Proof documents:

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