Local Government

APPLICATION FOR CONSENT TO USE A ROAD

Name of Applicant (Company Name & Contact Name):

Postal Address:                                                                                                                                 

Phone/Cell  Numbers:                                                                                                                      

Email Address:                                                                                                                                   

Date of Travel:  IN _______/_________/_______    OUT  _______/_________/_______

Haul Routes (Road Name/Desc):

Approved Trucking Companies:

               Trucking Company               Contact Name                       Phone #

Vehicle Details:                                                                       Weight:           # of Axels:

Purpose of Use / Reason for Request:

CONDITIONS:

1. Should the Road(s) specified in the above “Haul Routes” suffer any damage as a result of the Consent, the Applicant agrees to reimburse the Municipality 50% for all repairs made to the “Haul Routes”. The Grantee accesses and uses the specified Road(s) at its own risk.

2. The consent may be revoked by:

a.      If weather conditions vary from the date on which the Consent is granted

b.      If the Road(s) specified in the above “Haul Routes” suffers any damage prior to or as a result of the use of the Road pursuant to the Consent; or

c.       At any time at the discetion of the Rural Municipality of Ellice - Archie

3. The Consent is for the specified Road(s) and the duration, purpose and vehicle(s) stated in the Application.

4. The original Consent application and approval letter must be carried in the vehicle or primary vehicle if there are more than one at all times and shall be presented to any authority that requests such documents.

5. The Grantee must not cause any nuisnace, damage, disturbance, danger, risk or hazard to the occupiers of land adjacent the specified Road(s).

6. The Grantee must not carry out any civil works or improvements on or around the specified Road(s) without consent from the Rural Municipality of Ellice - Archie.

7. The Grantee must ensure that the vehicle(s) to be driven on the specified Road(s) are insured.

The Grantee must ensure that its agents, contractors and employees comply with the Consent and Schedule A of same.

Dated this _____ day of _______________, 20…..

_______________________________                      _______________________________

                                                                                    Trisha Huberdeau, CAO

Company Representative                                           RM of Ellice - Archie