Application: National Wildlife Area permit under the Wildlife Area Regulations

Official title: Application for a National Wildlife Area permit under the Wildlife Area Regulations

All information included in this application will be treated as confidential. Personal information collected as part of the permitting process is protected under the Privacy Act.

Important: Please consult the document “Instruction sheet: Applying for a National Wildlife Area permit under the Wildlife Areas Regulations” when filling out this application.

Section 1: Applicant information

1.1 Applicant contact information

Given name (please print):

Ssurname (please print):

Mailing address (number and street, incl. p.o. box if applicable):

City:

Province/territory:

Postal code:

Email:

Daytime telephone:

Other telephone:

Fax (if applicable):

Organization (if applicable):

Position title:

1.2 Previous permits

Have you previously been issued a permit by the Canadian Wildlife Service (CWS)? yes / no

If yes, please indicate the number of the permit(s):

1.3 Current application

Please indicate the purpose of the current application (select only one):

New Permit
Permit Renewal
Permit Amendment

If a renewal or amendment, please indicate the number of the previous permit:

Additional permits required to undertake the project (e.g. Species at Risk Act permit, Migratory Birds Regulations permit, etc.):

Section 2: Scope of project

2.1 Project description

Describe the type of project (e.g., monitoring, surveying, research, stewardship, interpretation, assets management, construction, restoration, etc.). Specify project goal and objectives. (add another sheet if needed)

2.2 Activity location information

Name(s) of the National Wildlife Area(s) (NWA):

Geographic coordinates of the activity. Provide UTM (Universal Transverse Mercator) grid or latitude/longitude coordinates (enter multiple coordinates for activities occurring over a large area). Attach a map if possible:

2.3 Proposed permit duration

Start date (yyyy-mm-dd):

End date (yyyy-mm-dd):

Provide details regarding the timing, duration, and frequency of visits.

2.4 Proposed activities

Identify all activities that that will be conducted within the protected area. (Check all that apply) Applicants should review the list of Authorized Activities in Schedule I.1 of the Wildlife Area Regulations to determine if a permit is required for that activity.

2.5 Environmental impacts

Describe all likely direct, indirect, incidental and cumulative environmental impacts of the project (e.g. impacts to land/soil, water, vegetation, wildlife, wildlife habitat, air quality, pollution, etc.). What is the likelihood that effects will occur? What is their scope (magnitude and scale)? Are any species at risk present/potentially present within the NWA and project area? If so, will there be any impact to individuals, residences or critical habitat? Describe the ability of the wildlife or wildlife habitat to rehabilitate itself or be restored if these effects occur.

2.6 Consideration of alternatives

What alternative methods were considered that would be less damaging to the wildlife and its habitat? Why conduct the activity in a National Wildlife Area? Are there other locations where this activity could be conducted?

2.7 Mitigation measures and risk management

Describe how impacts to land/soil resources, water resources, vegetation, air quality, wildlife, and wildlife habitat will be prevented and if prevention is unfeasible, how they will be mitigated (e.g. timing windows, cleaning machinery, hazard mapping, spill response kits, erosion control measures, etc.). Explain how you know these mitigation measures are proven and how their effectiveness will be monitored throughout the duration of the project.

Section 3: Equipment use and waste management

3.1 Equipment use

Will you be using firearms? yes / no

If yes, please also include them with the other equipment in the section below.

List all equipment, fuels and other hazardous materials to be used (e.g. generators, large tent structures, brush cutters, research equipment, etc.)

Equipment and hazardous materials

Proposed use

Amount/size (if applicable)

3.2 Conveyances, devices and fuels

List all devices, conveyances and fuel that will be used.

Device, conveyance and fuel

Proposed use

Amount/Size (if applicable)

3.3 Waste disposal

Type of waste

Quantity produced

Proposed disposal method

Section 4: Wildlife management

4.1 Likely effects to wildlife or habitat: yes / no

Is the proposed activity likely to involve taking, killing, capturing, or disturbing wildlife, its habitat and/or its residence?

If yes, please answer all questions in section 4.1.

If no, please proceed to 4.2.

4.1.1 Provide a justification for taking, killing, capturing or disturbing wildlife, its habitat and/or its residence.

4.1.2 Provide your methods and attach your scientific protocol.

4.1.3 Indicate which species will be affected and estimate how many individuals of those species will be affected.

If you will be damaging, removing or harvesting a plant, please list it here. If a species is listed in Schedule 1 of the Species at Risk Act, please check the box under the column labeled “SARA”. Please list additional species in Appendix B, as needed:

Common name

Scientific name

Number of individuals

SARAFootnote 1 yes / no

4.1.4 Describe your experience relevant to the proposed activity and include a list of qualifications you possess.  

4.2 Bird banding

Will you or a nominee be undertaking activities under a Scientific Permit to Capture and Band for this project? yes / no

If yes, please provide the number(s) of the Scientific Permit(s) to Capture and Band (please attach a copy of the applicable permits) :

Section 5: Nominee(s)

Other than yourself, will nominees be engaged to undertake the activities listed on this application? yes / no

If yes, please use Appendix C to list nominees.

Section 6: Signature of the applicant

I, (please print) hereby certify that

Signature:

Signature of the applicant

Date (yyyy/mm/dd)

Appendix A: Documents attached to this application

 Please list in order (e.g. notes, maps, reference documents, etc.)

Appendix B: Affected species (if applicable) (cont. section 4.1.3)

Common name

Scientific name

Number of individuals

SARAFootnote 2 yes / no

Appendix C: Nominees (if applicable) (cont. section 5)

Name and position, if applicable

Organization (if applicable) and address

Telephone number(s)

Qualifications

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