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Scale Site Application Form

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SCALE SITE APPLICATION

Energy, Mines and Resources

Version française

In Accordance with the Yukon Timber Regulations, Section 16, I hereby apply for authorization as an ofﬁ cial site of scale for

timber.

Site (Company) Name: _______________________________________________________________________________

Site (Company) Mailing Address: ______________________________________________________________________

Contact Name: _____________________________________________________________________________________

Location of the scale site: _____________________________________________________________________________

Product to be scaled and scaling method: ________________________________________________________________

(i.e. sawlogs, building logs. Piece scale, weight scale or both)

To scale wood from a single permit. If yes, permit # ______________

To scale wood from more than one permit

Estimated Start-Up Date of Scale Site (MM/DD/YY):_______________________________________________________

Scaled timber incoming? Y/N__________________________

Scaled timber outgoing? Y/N______________________

Land Use Permit (If applicable) #

Expiry Date (MM/DD/YY)

Lease #/Lot # or other:

Workman’s Compensation #

(If not applicable, please attach letter stating ofﬁ cial reason)

GST #:

(If not applicable, please attach letter stating ofﬁ cial reason)

BC Scale Site a copy of their valid, active, B.C. Ministry of Forests scale site authorization letter is attached:

Yes or No:___________________

_________________________________________________

____________________________________________

(Site owner signature)

(Date)

_________________________________________________

____________________________________________

(Telephone number)

(Fax number)

For Departmental Use Only

APPROVED: YES

COMMENCEMENT DATE:

SITE NUMBER:

EXPIRY DATE:

SIGNATURE:

Access to Information and Protection of Privacy Act

The personal information requested on this form is collected under the authority of and used for the purpose of administering the Yukon Timber Regulations.

Questions about the collection and use of this information can be directed to the Tenures Forester, Forestry Branch, Department of

Energy, Mines and Resources, Yukon Government, Box 2703, Whitehorse, Yukon Territory, Y1A 2C6 (867) 393-7904.

YG(5012Q) F2 04/2003

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