SCHEDULE B

TOWN OF VIEW ROYAL MONTHLY VOLUME REPORT

THIS SCHEDULE TO BE FILLED OUT MONTHLY AND SIGNED BY THE PERMIT HOLDER AND RETURNED TO THE TOWN OF VIEW ROYAL AS PER SECTION 19 OF THIS BYLAW:

Permit Information

Soil Removal or Deposit Permit No. __________________________________
Date of Issue __________________________________

Land Identification Information

Legal description _________________________________________________________________________
Municipal address _________________________________________________________________________

Land Ownership

Registered owner _________________________________________________________________________
Address of owner __________________________________________________________________________
Lease holder ______________________________________________________________________________
Address of lease holder ____________________________________________________________________

I hereby declare that during the period _____________________ to _____________________ inclusive, the volume of Soil removed was _______________ cubic metres and that the volume of Soil deposited was_______________ cubic metres.

Signed: ________________________________________________ Date: _____________________

(address)

(position title, owner, lessee or signing officer of limited company)