Murals on Private Property Form

Murals on Private Property Form
Applicant Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Site Information and Proposed Mural Location
Type of Site*

Private ResidenceBusinessInstitutionOutdoor InfrastructureOther
Site Address / Location*
Images of Mural Location*

Recent photos must be included. Google street view images will not be accepted. Accepted file types: pdf, jpg, jpeg, png, gif.
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Are there heritage considerations at this location?*

YesNo
Is the site a designated heritage property under the Ontario Heritage Act – Part IV and Part V and/or included in the City of Kingston Heritage Registrar?*

YesNoNot sure
Is the site a listed heritage property under the Ontario Heritage Act – Section 27?*

YesNoNot sure
Is the site located in the Lower Princess Heritage Character Area?*

YesNoNot sure
Property Owner Information
Are you the property owner?*

YesNo
Property Owner Name*

First NameLast Name
Property Owner Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
Property Owner Email*
example@example.com
Property Owner Phone Number*
Please enter a valid phone number.
If the applicant is not the property owner, proof of permission from the property owner must be supplied with the application, i.e., a letter from property owner stating permission is granted to install a mural.
Attach Proof of Permission*

i.e., a letter from property owner stating permission is granted to install a mural. Accepted file types: pdf, doc, docx, jpg, jpeg, png, gif.
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Proposed Mural Description
Mural Artist(s) Name*
Description of Proposed Mural*
Dimensions of Wall/Location for Mural*
Height and width in feet/inches
Attach draft artwork image/sketch and rendering that includes a draft artwork super imposed on a photo of the wall *

Accepted file types: pdf, jpg, jpeg, png, gif.
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Mural Installation and Maintenance Plans
Please note: these additional items are not part of the assessment, review and approval process and criteria, but are included as part of the application to ensure success of the mural project and so that City staff can offer support and guidance.
Outline the proposed materials to be used
Provide a brief installation plan and timeline
Describe the mural maintenance plan and proposed life span of mural (minimum two years)
Upload the budget template provided or use your own.
Budget

Accepted file types: pdf, doc, docx, xls, xlsx, csv.
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Notice of Collection

Personal information, as defined in the Municipal Freedom of Information and Protection of Privacy Act, is collected under the authority of the Municipal Act, 2001, and in accordance with MFIPPA. Personal information collected on the application form will be used to assist in selecting appointees for the various civic bodies and may form part of the publicly available meeting agendas and minutes. If appointed to a civic body, your personal information may also be used by City staff to conduct committee and City business. Questions regarding the collection, use, and disclosure of this personal information may be directed to Blair Johnson, at 613-546-4291 extension 1316 or bjohnson@cityofkingston.ca
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Murals on Private Property Form

Applicant Information

Site Information and Proposed Mural Location

Property Owner Information

Proposed Mural Description

Mural Installation and Maintenance Plans

Notice of Collection