Application to the Existing Leases Land Access Panel for Right of Entry Order

Please use the submit button at the bottom of the form to print this form once you have entered in all your information

(*) indicates required field View explanatory note

Applicant Information
*Name / Company Name:
*Address 1:
Address 2:
*City:
*Province:
*Postal Code:
*Phone:
Fax:
*Contact Person:
*Email:

Mineral Agreement(s) - Alberta Energy

You must be the holder of a mineral lease dated on or before November 1, 1990 from the Crown in right of Alberta, or making an application in respect of such a lease, to apply to ELLAP.

Development Plans
*Are there any Settlement Development Plans in effect for the parcels described this application?
Yes
No
Additional Surface Access
*Do you have a right of entry, but require additional surface access?
Yes
No

Occupant

Occupant means a settlement council, the person in actual possession of a parcel of patented land, and a person having a right or interest in patented land that is registered in the Metis Settlements Land Registry (see s. 111(h), Metis Settlements Act, RSA 2004).

Notice & Consents
*Have the occupants been served with notice and consent forms concerning this application?

If occupants have refused to consent, describe attempts that have been made to obtain their consent.



You have characters left.
Purpose of Application (Please check appropriate box)
 Well site    Production facility    Transmission line    Access road    Pipeline  Other
Land Description(s)
(example: NW-00-000-00-W0M)
Occupants
Certification and Undertaking (Please check appropriate box)
I certify the information on this application is true and undertake to comply with all applicable legislation, Metis Settlements General Council policies, Settlement bylaws, and development or land use plans.

Name of Signatory
Signature
Date

Print, sign, attach required documents, and mail original to the following:


9th Floor, Forestry Building
9920 - 108 Street
Edmonton, AB T5K 2M4

Phone: 1-800-661-8864 or 780-422-1541
Fax: 780-422-0019