aa
x ar ca
eis de

A eet
Opn 4 be Me]
Aa ORAL

I, Cacee arse’ _» certify that all information contained herein fs

true to the best,of myknowledge, ‘

LE Lonel ad teil tele Mag tUbL nnn
Applicant's Signat Date
or Representative’:

APPLICANT: ;
Name (Ld es zitec. 212 Seanstoare tire dat ABKIA LE
Address 2808 20) Sone0T ee et

Avenue ~~ Hb Le — _ Postal Code yew ft _
Company Incorporation Number === Occupation

Age 19 Yrs _ Yes Canadian _ Yes ss Resident in B.C. Yes
or Over __. No Citizen — _ No for 2 Yrs No

Contact eae Ra tia _ Phe fore LOL

B. APPLICANT'S REPRESENTATIVE:
Name .

Address

Ne eT enh let etm mn Ore Mme ori GA nmr GR) CRA GWT GUUS GFE Gt) Gee omef) TA Bukt sah GO OM GUL ane went

‘ ’
mh COTE CULE THE im FTE EY RRR ET fame SO Ceri GeerL pee LEO Meee Gnome Ge GY SE MT WP SR) GUN SRT. Geral WOE Gnd eneth mint? alee

Postal Code _ _ Contact
phi.

orn We Uns ions fm ene OOND eed one eee
’

RIPARIAN OWNER: Lo"

Name west, ut Tatuce$ eo TAT Ite Mb mal
Address

(ON ARN GUNN) ICEL ORAL “EE EHRs COIR TNE CH ORE OTR Cm GER ete) fame alt mY Lely mE HTD GET ORM Bel Ge KO! eee) a

AND A OED GRO ATE MER GUE TRL AOU GPE GORY GC SPOT) GENRE GER GUN Gly ane GOW OD GIG ORM CEM eet) anchor am mre Gem cue
1 ’

Postal Code Contact

ph.

a we Ee ene enn eee cee ae ene

SURVEYOR:

Address _

Ce Ree eee ee ee a ee

{AR OUND Gane COU GTEN OMY CE GHG CULE CEE GER CEUP GENRE HOON WHER CIM OF EN GEER CAND FED Ge GRE CRED GUN GE ee emt om ann

Postal Code co Contact
ph.

ore enen EL GO een om cE ame eet one

ATTACHMENTS REQUIRED Required Attached

- so rfparfan owner's consent MLE.
current copy of certificate of title : MA

site plan (20 copfes)
construction drawing (26 copies) |
dredge borrow and spoil plan (20 copies) | LE...
waste management permit application (4 copies) 4%):
pesticides perait application (7 copies) ME.
ecean dumping permit application  .
water approval application (2 copfes) . - sy