P-41.1, r. 1 - Preservation of Agricultural Land and Agricultural Activities Regulation

Schedule Disposition versions

2012-09-01

SCHEDULE VI

(s. 9)

APPLICATION FOR PERMIT

HOW TO FILL OUT THIS FORM

(1) Use:

Use this form only to apply for a permit to remove topsoil or lawn turf.

For other land uses, see the APPLICATION FOR AUTHORIZATION forms.

(2) Applicant:

The applicant must be the owner or the prospective buyer of the lot(s) covered by the application. If he is the prospective buyer, he must provide the commission with a copy of the duly signed and dated agreement to sell, and fill out section 2.

(3) Owner:

The owner of a lot is the person who is designated owner in the notarized deed of sale registered with the registry office of the registration division. A copy of the title deed must accompany your application.

(4) Mandatary:

A mandatary cannot be an applicant. He must also fill out section 4.

(5) Cadastral designation:

The name of the cadastre is not necessarily the current name of the municipality. The cadastral designation is usually shown on the title deed or the location certificate. Every lot or part of a lot covered by the application must be described in this form.

You must provide a photocopy of the title deed of every lot covered by the application and a technical description indicating lot boundaries if this information is not included in the title deed.

(6) Physical characteristics:

Indicate the locations of physical characteristics, constructions and structures and the current use(s) of the lot(s) as precisely as possible on the detailed plan required under section 9.

(7) Current use:

Indicate current use(s) of the neighbouring lot(s) with the corresponding area(s) on the plan.

(8) Site restoration program:

Explain each point listed under section 8 fully. Any planned site restoration program includes an agreement that will be a condition for authorization.

The commission reserves the right to clarify or modify the site restoration program or to have it clarified or modified.

(9) Plan:

Whether an application relates to a single lot or a group of lots, every applicant must provide the plan under this section so that the commission can consider the application.

(A) How to file your application

Send a copy of this form and all of the documents described below directly to the Commission de protection du territoire agricole du Québec.

Attach the following documents to your application:

(a) a detailed plan of the lot(s) covered by the application;

(b) a photocopy or duplicate of every registered title deed;

(c) any other relevant documents; and

(d) a certified cheque or money order for 10 $ payable to the Minister of Finance of Québec.

Note: Every plan must include the scale used in drafting, the date the plan was prepared and the signature of the person who prepared it.

(B) If you wish to be heard at a public hearing, check this box: □

(1) Send the white copy of this form to:

Commission de protection du territoire agricole du Québec

200, chemin Sainte-Foy

2e étage

Québec, Qc

G1R 4X6

(2) Keep the pink copy for your records.

APPLICATION FOR PERMIT

Note: Fill this form out carefully and attach all of the required documents to expedite the handling of your application. An incomplete form will be returned to the applicant and the application may be rejected.

(1) Check the box that indicates the nature of your application. (Guideline 1)

A) Removal of topsoil □

B) Removal of lawn turf □

(2) Applicant (Guideline 2)

Name: ___________________________________ Social Insurance Number: __________________

Address: _________________________________ Principal occupation: ______________________

Municipality: ______________________________ Telephone: Residence: ____________________

Postal code: ______________________________ Business: _____________________

(3) Owner (If different from applicant) (Guideline 3)

Name: ___________________________________ Social Insurance Number: __________________

Address: _________________________________ Principal occupation: ______________________

Municipality: ______________________________ Telephone: Residence: ____________________

Postal code: ______________________________ Business: _____________________

(4) Mandatary (Guideline 4)

Name: ___________________________________ Social Insurance Number: __________________

Address: _________________________________ Principal occupation: ______________________

Municipality: ______________________________ Telephone: Residence: ____________________

Postal code: ______________________________ Business: _____________________

(5) Location of the lot(s) covered by the application (Guideline 5)

Municipality: _________________________________________________________________________

County: ______________________________________________________________________________

Cadastral number: ______________________________________________________________________

Registration division: ___________________________________________________________________

     ______________________________________________________________________________
    |                   |                   |                                      |
    |     Lot number    |       Name of     |         Total area of the lot        |
    |                   |   the concession  |______________________________________|
    |                   |      or range     |                     |                |
    |                   |                   |       owned by      |   covered by   |
    |                   |                   |      the owner      | the application|
    |___________________|___________________|_____________________|________________|
    |                   |                   |                     |                |
1.  |___________________|___________________|_____________________|________________|
    |                   |                   |                     |                |
2.  |___________________|___________________|_____________________|________________|
    |                   |                   |                     |                |
3.  |___________________|___________________|_____________________|________________|
                                            |                     |                |
                                      Total |_____________________|________________|    

Note: Attach a photocopy or duplicate of the title deed of every lot covered by the application.

(6) Description of the lot(s) covered by the application

A) List the current use(s) of the lot(s) and indicate the area of each use: residence, commerce, industry, recreation, agriculture: type of product or crop: fallow land, woodlot, sugar bush, cereals, other. Indicate these uses on the plan required under section 9 also.

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

B) Describe all existing constructions and structures on the lot(s): house, building and any permanent structure. Include this information in the plan required under section 9.

     ______________________________________________________________________________
    |                        |                               |                     |
    |      Lot number        |      Type of construction     |        Area         |
    |________________________|_______________________________|_____________________|
    |                        |                               |                     |
1.  |________________________|_______________________________|_____________________|
    |                        |                               |                     |
2.  |________________________|_______________________________|_____________________|
    |                        |                               |                     |
3.  |________________________|_______________________________|_____________________|

C) Give the main physical characteristics of each lot covered by the application: swamp, woodlot (type of stand), hill, river, mountainous terrain, road, servitude. Include this information in the plan required under section 9.

     ______________________________________________________________________________
    |                        |                                                     |
    |       Lot number       |               Physical characteristics              |
    |________________________|_____________________________________________________|
    |                        |                                                     |
1.  |________________________|_____________________________________________________|
    |                        |                                                     |
2.  |________________________|_____________________________________________________|
    |                        |                                                     |
3.  |________________________|_____________________________________________________|

D) Note any public water and sewer services installed or prescribed by a municipal by-law that serve the said lot(s). Give the number of the by-law and the date on which it was adopted and show the locations of these services on the plan required under section 9.

_____________________________________________________________________________________

_____________________________________________________________________________________

E) If the owner owns one or more lots contiguous to the lot(s) covered by the application, even if separated from the latter by a public road, specify the respective cadastral number(s), area(s) and use(s) and locate it or them on the plan required under section 9.

_____________________________________________________________________________________

_____________________________________________________________________________________

(7) Description of lots of neighbouring owners

A) List and specify the use(s) of lots adjacent to the lot(s) covered by the application.

              _____________________________________________________________________
             |                 |                                                   |
             |    Lot number   |  Agricultural use(s) (indicate the type of        |
             |                 |  production: pasture, hay, cereals, vegetables,   |
             |                 |  raising of poultry, dairy production, hog        |
             |                 |  production, etc.) and non-agricultural use(s)    |
             |_________________| __________________________________________________|
             |                 |                                                   |
TO THE NORTH |_________________| __________________________________________________|
             |                 |                                                   |
TO THE SOUTH |_________________| __________________________________________________|
             |                 |                                                   |
TO THE EAST  |_________________| __________________________________________________|
             |                 |                                                   |
TO THE WEST  |_________________| __________________________________________________|

B) If any lot covered by the application borders on a public road, specify the use made of the lot situated on the other side of the road.

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

(8) Indicate:

A) the area under operation: ______________________________________________________________

B) the area covered by the application: ______________________________________________________

C) the kind of material removed: __________________________________________________________

D) the depth of removal: _________________________________________________________________

E) the planned site restoration program: ____________________________________________________

(Guideline 8) _______________________________________________________________________

_____________________________________________________________________________________

(9) Plan:

For each application, the owner or the applicant must provide a detailed scale plan showing:

a) all of the owner’s property covered by the application, with locations of buildings;

b) any lots adjacent to the side under consideration and their use(s), as required under section 7;

c) the area:

1. under operation; and

2. to be developed.

Note: Draft the plan to scale and indicate the cardinal points (north, south, east and west) correctly. You may attach any photograph, copy of the cadastral plan or other document that could facilitate consideration of your application.

(10) Additional representations:

You will have an opportunity to make additional written submissions, if you consider it appropriate. On receipt of your application, you will be notified of the date on which it will be heard and of the period during which you can file submissions.

Declaration

I declare that the information given in this form and in the attached documents is true and accurate .

Applicant’s signature ________________________________________ Date ________________________

Owner’s signature ___________________________________________ Date ________________________

(if other than applicant)

Mandatary’s signature ________________________________________ Date ________________________

(if applicable)

O.C. 1163-84, Sch. VI.