SPECIAL CIRCUMSTANCES PERMIT

SPECIAL CIRCUMSTANCES PERMIT
For use only after Ban Season. Cost of this Permit will be $100.00

MUNICIPAL TRANSPORTATION PERMIT FOR MOVING WITHIN THE R.M.
PERMIT NO: R20 /C
Type **ONE (1) PERMIT PER JOB REQUIRED** *

Agriculture Oil Other
Date *

Month Day Year
Date
Time frame for work (Start to Finish) *
Company Requesting Permit *
Name (Authorizing Person) *
Contact Number *
Please enter a valid phone number.
Email *
example@example.com
Reason Request Required *
Service Required *
Accurate Land Location *
IF LOCATION IS NOT CORRECT WHEN WE CHECK, THIS PERMIT IS VOID.
Route: (from Highway and location to location) this must be an approved route! *

If more space is required please use Note area below. 0/150
NOTES
- THIS ROUTE MUST B E AN APPROVED R OU T E FROM THE RM NO. 290.
- I F THE SERVICE BEING U SED DOES N OT US E APPROVED ROUTE THIS PERMIT IS VOID.
- IF THERE I S ANY DAMAGE THAT OCCURS DURING THIS PERMITS M OVE TO ANY ROADS THAT (I/WE) ARE RESPONSIBLE FOR COST OF REPAIRS.
- THIS P ERMIT IS SUBJECT T O THE TERMS AND CONDITIONS STATED ON OUR OFFICIAL WEB SITE: rmofkindersley.ca
- ROAD RESTRICTIONS (LIST OF RULES WHILE TRAVELLING WITHIN THE R.M.)
Signature *

Your digital name is your signature Clear
Should be Empty: