Dust Control

YOUR CONTACT INFORMATION

ACCOUNT INFORMATION

Hereinafter called the APPLICANT(S) and the MD of Pincher Creek, hereinafter referred to as the MD, the APPLICANT(S) do hereby request the following dust suppression be done as outlined below:

example: SW 30-2-29 W4M

metres

In consideration of the mutual covenants contained in this AGREEMENT, THE PARTIES AGREE AS FOLLOWS:

Dust Control suppressants will be applied in accordance with corporate policy C-PW-009 Dust Control. Please refer to policy for all necessary information.
To allow for product ordering and timelines, if your agreement is not completed prior to the application deadline of May 1, there is no guarantee the service will be completed that year.
By signing this document, you hold harmless and indemnify the MD from all liability for injury, death, property damage, property loss, or any other loss or expense to any party, including any other financial loss or expense, including, without restriction. Legal expenses and costs on a solicitor-and-his-own-client full indemnity basis as a result of the MD supplying materials or services.
The applicant agrees to pay the Municipality a charge as per Policy C-FIN-529 Fees and Charges (which states a cost of $325.00 per 100 meters for individuals/$720.00 per 100 meters for commercial)

I acknowledge that I have read, have had the opportunity to ask questions and clarifications before signing, and understand this entire application form including the waiver of Liability and release and I agree to be legally bound by it.

Please type your name here to accept the Terms and Conditions:

Important – Applicant Must:

Measure and mark the beginning and end of the section with ribbon on the fenceline.
The MD reserves the right to adjust the section length to the agreed amount should a discrepancy exist.

This personal information is being collected under the authority of the MD of Pincher Creek No. 9 as it directly relates to and is necessary for operating a program or activity of the MD. This collection is authorized by section 4 of the Protection and Privacy Act. For questions about the collection of personal information, contact the Privacy Officer at 403-627-3130, MD Box 279, Pincher Creek, Alberta T0K 1W0 / 1037 Herron Ave / P 403-627-3130 / F 403-627-5070 / info@mdpinchercreek.ab.ca.