MUNICIPAL CLERK

Dear Sirs -

RE: APPLICATION FOR EXEMPTION - SECTION 400(2) (e) , (d)
MUNICIPAL ACT

{t wish to make application to the Municipal Couneil to have exempted
under Section 400 of the Mumicipal Act the space eceupied ia School

Board property by the non~profit organization named below:

ORGANIZATION NAME

ADDRESS s
REPRESENTATIVE :
- (PHONE NUMBER) ;
NAME OF SCHOOL WHERE :
SPACE IS LEASED ;
PROPOSED USE OF ;
LEASED SPACE. :
START DATE OF LEASE : =
CUMPLETION DATE OF LEASE :
OTHER DETAILS ;
Yours truly,
ee/ B.C. ASSESSMENT AUTHORITY

$410-2755 LOUGHEED HNY.,
PORT COQUITLAM, B.C. V3B 5Y9