"Application for Agricultural Liming Materials Permit" - Alabama

Application for Agricultural Liming Materials Permit is a legal document that was released by the Alabama Department of Agriculture and Industries - a government authority operating within Alabama.

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Download "Application for Agricultural Liming Materials Permit" - Alabama

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A
S
tate of
LABAMA
D
A
I
EPARTMENT OF
GRICULTURE AND
NDUSTRIES
Audits & Reports Section
1445 Federal Drive, Montgomery, AL 36107-1123
(334) 240-7263 ● 1-800-642-7761, Ext. 7263 ● Fax (334) 240-7187
Rick Pate, Commissioner
www.agi.alabama.gov
APPLICATION FOR AGRICULTURAL LIMING MATERIALS PERMIT
For Period October 1, 2020 through September 30, 2021
The undersigned hereby makes application for Agricultural Liming Materials Permit as required by Chapter 2,
Title 23, Code of Alabama (1975) as amended. A permit is required for every manufacturer or distributor selling
agricultural liming materials in Alabama.
INSTRUCTIONS
1. Provide the firm name and complete address (including zip code) in the space provided.
2. List the types of agricultural liming materials manufactured and / or distributed in Alabama utilizing the types
of such materials defined under Alabama law (i.e. “Calcitic Limestone”, “Dolomite Limestone”, “Chalk”, etc.)
3. Submit a complete label, or label information for each of the types and brands of agricultural liming material
you will manufacture and sell under your permit.
4. Submit $250.00 for the first type or brand of agricultural liming material the company will manufacture and/ or
sell under its permit and $125.00 for each additional type or brand registered under this permit.
Name of Business:
Phone (
)
Address:
Fax
(
)
_
_____________________________________________
______________
Zip Code:
Type(s) of Agricultural Liming Material
Brand Name(s)
1.
________________________________________
___________________________________________
2.
________________________________________
___________________________________________
3.
________________________________________
___________________________________________
4.
________________________________________
___________________________________________
5.
________________________________________
___________________________________________
In filing this application for a permit, the undersigned agrees to comply with the Alabama laws, rules, and
regulations promulgated thereunder.
SIGNATURE ______________________________________________ TITLE _______________________________
PRINT NAME ______________________________________________ DATE _______________________________
EMAIL ADDRESS ______________________________________________
***Application must be signed. Make check payable to the Alabama Department of Agriculture and Industries.
FOR OFFICE USE ONLY
Approved ______________________________
Amount of check _______________________
Date _________________________________
Permit Fee ____________________________
Data Entered By _______________________
Penalty
_________________________
Labels Yes
No ____
Total ________________________________
A
S
tate of
LABAMA
D
A
I
EPARTMENT OF
GRICULTURE AND
NDUSTRIES
Audits & Reports Section
1445 Federal Drive, Montgomery, AL 36107-1123
(334) 240-7263 ● 1-800-642-7761, Ext. 7263 ● Fax (334) 240-7187
Rick Pate, Commissioner
www.agi.alabama.gov
APPLICATION FOR AGRICULTURAL LIMING MATERIALS PERMIT
For Period October 1, 2020 through September 30, 2021
The undersigned hereby makes application for Agricultural Liming Materials Permit as required by Chapter 2,
Title 23, Code of Alabama (1975) as amended. A permit is required for every manufacturer or distributor selling
agricultural liming materials in Alabama.
INSTRUCTIONS
1. Provide the firm name and complete address (including zip code) in the space provided.
2. List the types of agricultural liming materials manufactured and / or distributed in Alabama utilizing the types
of such materials defined under Alabama law (i.e. “Calcitic Limestone”, “Dolomite Limestone”, “Chalk”, etc.)
3. Submit a complete label, or label information for each of the types and brands of agricultural liming material
you will manufacture and sell under your permit.
4. Submit $250.00 for the first type or brand of agricultural liming material the company will manufacture and/ or
sell under its permit and $125.00 for each additional type or brand registered under this permit.
Name of Business:
Phone (
)
Address:
Fax
(
)
_
_____________________________________________
______________
Zip Code:
Type(s) of Agricultural Liming Material
Brand Name(s)
1.
________________________________________
___________________________________________
2.
________________________________________
___________________________________________
3.
________________________________________
___________________________________________
4.
________________________________________
___________________________________________
5.
________________________________________
___________________________________________
In filing this application for a permit, the undersigned agrees to comply with the Alabama laws, rules, and
regulations promulgated thereunder.
SIGNATURE ______________________________________________ TITLE _______________________________
PRINT NAME ______________________________________________ DATE _______________________________
EMAIL ADDRESS ______________________________________________
***Application must be signed. Make check payable to the Alabama Department of Agriculture and Industries.
FOR OFFICE USE ONLY
Approved ______________________________
Amount of check _______________________
Date _________________________________
Permit Fee ____________________________
Data Entered By _______________________
Penalty
_________________________
Labels Yes
No ____
Total ________________________________