THE CORPORATION OF THE CITY OF PORT COQUITLAM

“SOIL REMOVAL REGULATION
BYLAW NO, 2666”

SCBEIULE “A”

Application for Soil Removal Permit No.

of
(full name) (address )

hereby apply for a permit to remove soil from the

(telephone)
following property:

Address

Legal Deseription

The registered owner of property from which the soil is to be removed

of
(full name (addrege )

(telephone)

If the applicant is not the registered owner of the property from

the soil is to be removed then the registered owner by signing here
authorizes the applicant to make this application
. . . ' Signature of Owner

The soil is being removed for the following purpose:

The ground area from which the soil is to be removed is hectares.

The total volume of soil to be removed is cubic metres.

Attached is a dimensioned sketch of the property from which the soil is to
be removed, showing all roads adjoining the property, the parcel
boundaries of the property, all existing buildings, structures and other
improvements, the location of water, sewer and other utilities as well as
natural watercourses, ditches, drains, manholes, culverts, catch basins
and other public works on or within 30 metres of the property, the
location of wells and septic fields on the property and on any adjoining
properties, and the exact location and depth of the soil to be removed.