SPECIAL CIRCUMSTANCES PERMIT
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
*
Email
*
example@example.com
Reason Request Required
*
Service Required
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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 Notes area below.
0/150
NOTES
THIS
R
OU
TE
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
R
ESPONSIBLE
FOR
COST
OF
REPAIRS.
THIS PERMIT IS SUBJECT TO 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
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