Form: FILMING PERMIT APPLICATION LOCATION SHEET

TOWN OF VIEW ROYAL FILMING PERMIT APPLICATION LOCATION SHEET

This application form must be completed for any filming on Town streets, in parks or in any other public space. Applicants are required to read the Permit Application guidelines and sign the statement on page 2 of this form prior to submitting the application. Completed application forms may be returned by mail, fax or email to: Town of View Royal, 45 View Royal Ave, Victoria BC, V9B 1A6 Inquiries: Phone: (250) 479-6800 Fax: (250) 727-9551 Email: info@viewroyal.ca

Please fill in a separate Location Sheet for each film location applied for, or if the location is the same but has different requirements for subsequent dates. Please specify the street names involved, and attach a marked map of the location, together with a detailed layout plan showing placement of production vehicles, etc. This application form becomes an approved permit when it is returned to you signed and dated (see over page).

• Applicant Organization:
• Phone:
• Contact Person:
• Cell Phone:
• Mailing Address:
• Fax:
• Film Name or Client:
• Location:
• Shooting Dates:
• Time of Shooting:
  • a) start and finish of shoot:
  • b) including set-up and clean-up:
• Approximate Number of Crew and Cast:
• Number of Production Vehicles and Type (eg. Cars, pick-up trucks, commercial vehicles):
• Name of main liaison person and how to contact before the shoot and on-site (eg. cell phone #):

(This person must have the authority to shut down the shoot in case of emergency or contravention of the permit conditions and must carry a copy of the approved permit on his / her person throughout the filming).

• Town of View Royal Electrical Permit Number:

(An electrical permit is required for all filming in the Town of View Royal. Please phone Town of View Royal (250) 479-6800 for electrical permit information.)

PLEASE COMPLETE AND SIGN PAGE 2

REQUEST FOR SPECIFIC REQUIREMENTS / TOWN SERVICES

Please detail specific production requirements, e.g. requests for site amendments, parking, Town services, etc., and sign and date application below.

On behalf of the applicant organization, I acknowledge that I have read and understood the conditions contained in the Filming Permit Application General Conditions and agree to comply with them and any additional conditions noted hereunder.

• Signature:
• Date:

OFFICE USE

• Deposit Received:
• Proof of Insurance:
• Electrical Permit:

Protective Services Department Comments/Approval:

• Signature:
• Date:

Engineering Department Comments/Approval:

• Signature:
• Date:

RCMP Comments/Approval:

• Signature:
• Date:

APPROVAL IS GRANTED SUBJECT TO THE FILMING PERMIT GENERAL CONDITIONS, AND TO THE ADDITIONAL CONDITIONS AND COMMENTS.

• CAO Signature:
• Date: