Land Access Permit Request Form

 
Please note that completion of this application does not constitute an approval.
  
Section 1 - For NCC Use Only
 
 
 
NCC Contact
 
 
 
Permit Number
 
 
Purchase Order Number
 
 
Agreement Number
 
 

  
 
 
Section 2 - Applicant Information
 
 
 
First Name*
 
 
Last Name*
 
 
Job Title*
 
 
Company Name*
 
 
Email Address*
 
 
Company Address*
 
 
City*
 
 
Province*
 
 
Postal Code*
 
 
Phone Number*
 
 
Cellular Phone Number
 
 
Language*
 
 

  
 
 
Section 3 - Signing Authority
 
 
 
First Name*
 
 
Last Name*
 
 
Job Title*
 
 
Email Address*
 
 
 
 

  
 
 
Section 4 - Activity Description
 
 
 
Start Date/Time*
 
 
End Date/Time*
 
 
 
Permit Type
 
 
Other
 
 
Location*
 
 
Specify Exact Location*
 
 
Equipment List*
 
 
Detailed Description of Activity*
 
 
Access Required (select all that apply)
 
Comments
 
 

  
 
 
Section 5 - Attachment(s)
 
 
 
NOTE: Please attach any further information you deem of interest, such as site maps and background information. 
 
 
 
File Upload
 
 
File Upload
 
 
File Upload
 
 
List of Attached Files
 
 

  
 
 
Section 6 - Land Use Fees and Liability Insurance

You may be required to obtain public liability insurance for a minimum coverage of $2,000,000 with the National Capital Commission listed as co-insured. Your Certificate of Insurance will need to be provided prior to the activity. Once your completed application is received, your activity will be assessed and fees will be communicated to you, if applicable. 

  
 
 
Section 7 - Environmental Sustainability

The National Capital Commission encourages all activity organizers to minimize the environmental impact of their activities and to implement strategies to improve the environmental, social and economic benefits from activities. Please include details of the measures you will implement to ensure that your activity will be managed to improve its sustainability. 

  
 
 
Section 8 - Contact Us

Telephone: 613-239-5000 ou 1-800-465-1867 (toll-free)

Email: info@ncc-ccn.ca

Your application will be assessed and you will be advised about: documentation and approvals required prior to granting a land access permit. The National Capital Commission takes no responsibility for any third party commitments entered into by the applicant if an application is declined.  


  
 
 
Section 9 - Applicant Declaration
I declare that all the information in the application is to the best of my knowledge, true and correct. I also understand that if the information is incomplete, the application may be delayed or rejected or more information may be requested. I acknowledge that if the information provided is misleading, any approval granted may be void. I accept delays in processing will arise out of any inadequacies in the material submitted in support of the application. I understand that this application, in no way, represents approval of the activity and/or a guarantee of the availability of the site. 

  
 
 
Applicant Name*