Additional form: authorization to conduct damage or danger permit activities on private property

Additional form showing the authorization to conduct activities on private property for purposes of Land Management Under the Migratory Birds Regulations

The Migratory Birds Regulations allow permits to be issued to a landowner or land manager. The term "land manager" is interpreted to include:

• a) a person who rents or leases specified lands or properties
• b) a person who has been authorized in writing to act as land manager for the purposes of migratory bird management on specified lands or properties; and/or
• c) a person who is the chair, coordinator, or signatory to a Canadian Wildlife Service-approved management plan, including municipalities and other large-scale landowners

Permits may be granted on the condition that permission is obtained from the landowner or land manager for any activities proposed on private lands.

Please fill out the following page for each location listed on your permit application as per b) and c) above, and include it with your application for review.

Thank you.

Signature Page

Designated permit applicant/permit holder Name (please print)

Organization

Permit number (if known)

Landowner, land manager^{Footnote 1}  or lessee

I, the undersigned landowner, land manager or lessee, hereby:

• attest that the damage and/or danger being caused by migratory birds is serious;
• authorize the designated permit applicant/holder to act on my behalf for the purposes of migratory bird management and/or in support of the implementation of a migratory bird management plan; and, grant permission to the aforementioned permit holder to access my property (specified below) in order to conduct the permitted activities for the duration of the permit term.

Name of the landowner, land manager or lessee (please print) :

Signature:

Date (yyyy/mm/dd):

Business name (if applicable):

Mailing address:

Address of property where permitted activities will occur (If multiple properties, please list all, separated by semicolons) :

Time period for which I authorize the permit holder to conduct the permitted activities in the properties listed above :

Note: when activities occur on properties that are not owned or leased by the permit holder, the permit must be accompanied by a valid signed letter of authorization to conduct damage or danger permit activities on the private property. The permit holder is responsible to ensure that the letter of authorization has been signed by the current landowner, land manager or lessee, as defined in the authorization, and that the latest authorization has been sent to the relevant Canadian Wildlife Office