New Single Family House Permit Application - City of Edmonton

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Page 4 of 6 Nov, 2012

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Page 4 of 6 Nov, 2012

DECLARATION – ABSENCE OF ABANDONED WELLS ON PARCEL I, _________________________________________________ , have reviewed Information from the Energy Resource and Conservation Board (“ERCB”) and can advise that the information shows the absence of any abandoned wells on the parcel that is the subject of the attached application for Development Permit. Subject Parcel: Plan No.__________________ Block ____________________ Lot _________________ Municipal Address: _______________________________________________________ ______________________________ Signature ______________________________ Printed Name ______________________________

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New Single Family House Permit Application - City of Edmonton

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