Application For A Machine Licence Under The Agricultural Tile Drainage Installation Act

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Business Name: ______________________________________________

Bus. Lic.#: _____________

Mailing Address: ______________________________________________

City: ___________________________________________

Postal Code: ________________________

Telephone: ______________________________________

Fax Number: ________________________

Note: To obtain a new machine licence, the Regulations under The Agricultural Tile Drainage Installation Act indicate that all machines must be able to install tile in accordance with specifications. To issue machine licence(s), an inspection of your machine(s) may be necessary. All machine licences are issued for a three-year term expiring December 31; the fee for this licence is $50.00.

1. Description of Machine(s):

2. The Licence Fee/Fees*: The total machine licence fee of $_____________________ accompanies this application ($50 for each machine listed above).

_________________________________________________________
(Signature of Applicant)

__________________________________________
(Date)

_________________________________________________________
(Name - please print)

_________________________________________________________
(Title of official signing for a corporation)

*Cheques or money orders must be made out to The Minister of Finance. A cheque tendered to the Government of Ontario and not honoured by your bank will be subject to a $35.00 service charge.

Please Submit Application and Payment to Address Below:

Ministry of Agriculture, Food and Rural Affairs
Drainage Licencing, Environmental Management Branch
1 Stone Rd. West, 3rd Floor
Guelph, Ontario N1G 4Y2
Telephone: 519-826-3552
Fax: 519-826-3259

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