West Moberly Referrals Office

Submission Form

All fields with asterisks (*) are required fields. Upon clicking the “Submit” button at the bottom of the page, an email receipt will be automatically sent to the email address provided. Please contact [email protected] if you do not receive a receipt within 1 hour of submission.

This submission will not be processed if it is incomplete. Once you have submitted your form by clicking the ‘Submit’ button at the bottom of the page you may save a copy to your computer. Manually emailed copies of this form will not be accepted.

Part 1 – General Information

* Referral type

* File Number(s)

* Project Name

* Project Description

* Project Location

* Government Statute(s)

Part 2 – Applicant Information

* Name

* Email Address

Organization

Title

* Phone Number

Fax Number

* Street

* City

* Province

* Postal Code

Country

Part 3 – Proponent Information The applicant is the proponent

* Name

Email Address

Organization

Title

Phone Number

Fax Number

Street

City

Province

Postal Code

Country

Send notifications to the proponent

Spatial Footprint

Upload Spatial Files

Draw Footprint

Please attach a spatial data file that represents the footprint of the project area. Do not include other spatial areas like nearby rivers or roads in this file.

Add spatial filesSubmit spatial information in either KML/KMZ or shapefile format. If providing shapefiles, please zip (compress) contents into a single file, 'example projectxyzshape.zip'. Hold the ctrl key while selecting files to add more than one.

Supporting Documentation

Please attach any documents, assessments, road access instructions/map, or other supporting files.

Add a supporting document

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