Soil Deposit/Removal Application Form

Authorization of Owner/Leaseholder to make an Application

Date: ___________________________ Site Address: __________________________________________________________________________________

I/We _____________________________________________________________________________________________ are the registered owner(s) or leaseholder(s) of ________________________________________________________.

I/We authorize _____________________________________________________________________________________ (please print name(s)) to apply for the following: [ ] Soil Removal [ ] Soil Deposit on my/our behalf.

Professional Engineer’s Reports

Soil Removal or Deposit Information (Prepared by Professional Engineer)

Type of Material: ______________________________________________________________________________ Location: ________________________________________________________________________________________

Estimated quantity of Soil

• to be removed _________________________ $m^3$
• to be deposited ________________________ $m^3$

Estimate prepared by: _________________________________________________________________________ Date: _______________________________________

Attached, as part of this Application, are the following reports (include title, author, date):

1. ________________________________________________________________________________________________
2. ________________________________________________________________________________________________
3. ________________________________________________________________________________________________

Date which Statutory Declaration as per Schedule E is to be submitted by: ____________________________

Date Monthly Reports are due per this bylaw

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: ______________________________________ (owner)

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

A complete application for Soil Deposit/Removal contains:

• detailed plans, data, and specifications for the proposed site prepared by a Professional Engineer to a scale of not more than 1:1000, showing the topography in its current and proposed state with contour intervals of 1m or less;
• all pertinent features including buildings, structures, tree cover, roads, lanes, bridges, natural watercourses, shorelines and aquifers;
• the proposed slopes which will be maintained upon completion of the Soil deposit or removal operation, including information on the inclination of the finished slopes;
• the proposed methods to control the erosion of the excavated, filled or disturbed areas;
• the proposed methods of drainage control during the excavation or fill;
• the proposed methods and locations of access to the site during the excavation or fill;
• the topography of the ground in its final state upon completion of the operation with vertical contours as specified above and showing the method of access and methods of permanent drainage on a separate plan, including an analysis of the impact of the proposed work on local drainage patterns prepared by a certified hydrologist or other professional specified by the Town Staff;
• the proposed location of machinery, buildings, scales, and all other proposed structures and improvements;
• the proposed location of Buffer Zones and tree cover, and the location and grade width of berms;
• water well locations and water table elevations within the drainage area;
• the proposed method of extraction and processing, including sorting, washing, crushing, and any other proposed processing activities;
• the proposed schedule for the removal or deposit of Soil, indicating the amounts to be either removed or deposited on a weekly basis;
• the proposed routes over Town highways (roads) to and from a Soil Removal or Deposit Area;
• a Traffic Management Plan, which would include but not be limited to a description of the frequency of trucks, signage, placement of safety control devices, and other traffic control that would minimize the disturbance created;
• the general description and volume of the Soil to be removed or deposited;
• identification of whether the application is in whole or in part within an Environmental Development Permit Area identified within the Town's Official Community Plan. For any Removal or Deposit within an Environmental Development Permit area, an environmental assessment to the satisfaction of the Director of Development Services shall be undertaken and all applicable Development Permit Area Guidelines shall be identified and adhered to.
• identification of whether the application is in whole or in part within a Riparian Assessment Area. For any Removal or Deposit within a Riparian Assessment Area, written confirmation from a Qualified Environmental Professional shall be provided at the Permittee's expense, that the Deposit or Removal will be undertaken in compliance with the Provincial Riparian Areas Regulation;
• for an application for Soil deposit, a site profile consistent with provincial contaminated sites regulation, and whenever applicable a copy of the Soil removal Permit from the authority having jurisdiction of and for the site from which the Soil is or will be relocated; and
• copies of all certificates, permits, plans, orders, approvals, reports, and agreements which may be required or issued by the Province of British Columbia or by any other authority having jurisdiction over the proposed deposit and/or removal.
• A site reclamation plan including an Invasive Species Management Plan, prepared by a qualified professional to be incorporated into the Permit.

Contaminated Sites Information

Pursuant to the Waste Management Act, the Province of British Columbia requires an applicant to submit a Site Profile Form on properties that are or were used for commercial or industrial purposes as defined within the provincial regulations, i.e. Schedule 2 activities. Please indicate if the subject property qualifies for the following major exemptions for requiring a Site Profile:

[ ] The property has only been used for residential purposes [ ] There will be no disturbance or excavation of soil involved as part of your proposal

Signature of Applicant ______________________________________ Date ____________________________

If a major exemption does not apply, then please obtain the information package on the Site profiles from Planning Staff. More information is available at www.gov.bc.ca/wlap