Application for Water Use Exception Permit

Application for Water Use Exception Permit

Apply for an exception to Stage 4 water restrictions for specific washing activities.
This application is for businesses requesting an exception to Stage 4 water restrictions to carry out specific washing activities. Applications must demonstrate the necessity of the requested work, the severe financial impact of deferring the work, and the measures proposed to minimize water use. Submission of this application does not guarantee approval. Applicants must receive approval from the CVRD before proceeding with the requested activity.

“The personal information collected as part of this application are done so under the authority of Section 26 (c) of the Freedom of Information and Protection of Privacy Act and will be used solely for the purpose of water use exception permits. Should you have any questions about the collection, use and protection of your personal information, please contact by emailing administration@comoxvalleyrd.ca or by calling 250-334-6000.”
Applicant Information
Company / Business Name
Primary Contact Name

First NameLast Name
Telephone
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Date of Application

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Requested Washing Activity
Describe the specific washing activity for which an exception is requested. Include the equipment, vehicles, infrastructure, facilities, or other items to be washed, the purpose of the washing, and why the activity is necessary during Stage 4 restrictions.
Justification For Exception
Describe the severe financial impact to the business if this work is deferred until water restrictions are reduced or lifted. Explain the anticipated financial losses, additional costs, contractual or operational consequences, or other significant financial impacts.
Estimated Water Requirements
Estimated total volume of water required in Liters
Water source and method of supply
Proposed Water-Saving Measures
Describe the measures that will be implemented to minimize water use during the requested activity. Consider measures such as water-efficient equipment, low-flow or trigger-controlled nozzles, recycling or reuse of wash water, limiting washing to essential areas, and avoiding unnecessary rinsing.
Applicant Declaration
I confirm that the information provided in this application is accurate and complete to the best of my knowledge. I understand that the Regional District may approve, deny, limit, suspend, or revoke an exception to exterior commercial washing at any time, including where water supply conditions worsen or where the business fails to comply with the terms of approval. Bylaw No. 129
Applicant Name (print)

First NameLast Name
Applicant Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Application for Water Use Exception Permit

Applicant Information

Requested Washing Activity

Justification For Exception

Estimated Water Requirements

Proposed Water-Saving Measures

Applicant Declaration