A-111 Building Permit Application

Building Permit Application Form

Name

Mailing Address

City/Town

State/Province

ZIP/Postal Code

The undersigned applies for a permit to construct a tourist establishment or to make additions to the following classification

Lodge

Outpost Camp

Cabin Establishment

Camping Establishment

Hotel

Motel

Tourist Home

Other (please specify)

Enter other…

Name of proposed establishment

The proposed establishment is to be situated at:

Longtitude

Latitude

If the proposed establishment is not in a municipality or settlement, give the name of the nearest one

If the proposed establishment is on surveyed land:

Parcel

Lot

Block

Plan

The site is on:

Crown Lease

Federal

Inuit Owned Land

Sole Proprietorship

Partnership

The owner / owners are or will be registered with the Government of the Nunavut as:

Limited Company

Co-operative

Sole Proprietorship

Partnership

Name

Mailing Address

City/Town

State/Province

ZIP/Postal Code

The president and managing director, or of the two senior partners or of the proprietor are / is or will be:

Name and Title

Address

Construction

Beginning of Construction Date

Construction Completion Date

Number of people the tourist establishment will accomodate:

People

Please provide the following documents to support this application:

Structural plans, including fire safety equipment
Building specifications
Details of water supply, grey water disposal, sewage disposal, garbage disposal, petroleum fuel storage, fuel distribution locations used for refilling boats, aircraft, etc.;
Topographical map, municipal plan, or plan showing exact location and coordinates of site or sites;
Sketch plan to building site or sites

Please ensure you attach five (5) copies.

Supporting Documents

Unlimited number of files can be uploaded to this field.
100 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

Fee, made payable to Government of Nunavut

Payment of $

Enclosed

Signature

Sign above

Date

RETURN THIS APPLICATION, SUPPORTING DOCUMENTS AND FEES TO THE COMMUNITY OPERATIONS OFFICE IN YOUR REGION:
Community Operations North Baffin P.O. Box 389, Pond Inlet, NU X0A 0S0 (867) 899-7338 toll-free: (888) 899-7338 Fax: (867) 899-7348	Community Operations South Baffin P.O. Box 612, Pangnirtung, NU X0A 0R0 (867) 473-2679 toll-free: (888) 975-5999 Fax: (867) 473-2663
Community Operations Kitikmeot P.O. Box 316, Kugluktuk, NU X0B 0E0 (867) 982-7453 toll-free: (888) 975-5999 Fax: (867) 982-3204	Community Operations Kivalliq P.O. Bag 2, Rankin Inlet, NU X0C 0G0 (867) 645-8450 toll-free: (888) 975-5999 Fax: (867) 645-8455
email: @email	website: www.edt.gov.nu.ca

Steps

Current Building Permit Application Form
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