"Application for Basic Property-Based Environmental Information" - New Brunswick, Canada

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Application for Property Based Environmental Information
Applicant Information:
*
Contact Name:______________________
*
Company Name:_________________________
*
Street/PO Box:_________________________
*
Client ref#:_________________
*
City:_________________________
*
Phone:___________________________
*
Province:_______________________
*
Fax:___________________________
*
Postal Code:_______________________
*
Date:___________________________
*
Signature:________________________
*
Email:_____________________________
Property Information:
PID numbers are eight (8) digits in length. If the PID number to be searched contains less than eight digits please
place a zero (0) in front, as the remaining. (ex: 61385 = 00061385)
PID Number(s)
Civic Address
Property Owner(s)
*
Additional Information:
**
SNB: PLU 807000 (Please fax form to: 506-453-2390)
Please note that all mandatory fields are marked with asterisks (*). These fields must be completed in order to
process this application form. Incomplete application forms may result in delays.
A non-refundable fee of sixty-three dollars and twenty-five cents ($63.25 HST included) per PID for each request
is payable upon submission of the application. Cheques/Money orders are to be made payable to the “Minister of
Finance”.
Application for Property Based Environmental Information
Applicant Information:
*
Contact Name:______________________
*
Company Name:_________________________
*
Street/PO Box:_________________________
*
Client ref#:_________________
*
City:_________________________
*
Phone:___________________________
*
Province:_______________________
*
Fax:___________________________
*
Postal Code:_______________________
*
Date:___________________________
*
Signature:________________________
*
Email:_____________________________
Property Information:
PID numbers are eight (8) digits in length. If the PID number to be searched contains less than eight digits please
place a zero (0) in front, as the remaining. (ex: 61385 = 00061385)
PID Number(s)
Civic Address
Property Owner(s)
*
Additional Information:
**
SNB: PLU 807000 (Please fax form to: 506-453-2390)
Please note that all mandatory fields are marked with asterisks (*). These fields must be completed in order to
process this application form. Incomplete application forms may result in delays.
A non-refundable fee of sixty-three dollars and twenty-five cents ($63.25 HST included) per PID for each request
is payable upon submission of the application. Cheques/Money orders are to be made payable to the “Minister of
Finance”.
Department of Environment and Local Government
October 2019
Application/Payment Information:
Forward payment and application form to:
Mail:
Department of Environment
Environmental Management Division
PO Box 6000
Fredericton, NB
E3B 5H1
rd
(20 McGloin St., 3
Floor,
Fredericton, NB E3A 5T8)
Fax:
Dept. of Environment, (506) 453-2390
E-mail:
pidenvinfo@gnb.ca
Online:
www.snb.ca/pbei-iebb
In Person: Service New Brunswick offices
Department of Environment and Local Government
October 2019
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