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Ministry of Environment
Application to Purchase Crown Land
January 2020

I/We, of
Complete name(s) in full - initials unacceptable

Mailing Address City/Town Province

Postal Code Phone Number Email Address

hereby apply to purchase the following described Crown land, namely: Property Number

Parcel/Lot Block Plan Subdivision

OR

LSD Quarter Section Township Range West of the

As Joint Tenants: Yes No

1. I/We are the full age of 18 years.

2. I/We understand the sale of this property is subject to meeting the requirements of the Ministry of
Environment and approval by the Lieutenant Governor-in-Council.
3. An invoice for all administration fees, inspection fees, and the full purchase price will be issued after
completion of the government approval and must be paid prior to receiving land transfer documents.
4. Should the purchase of this land require subdivision or untying of parcels, the subdivision will have to
adhere to any municipal zoning bylaws that may exist and must receive approval from Community Planning
Branch, Ministry of Government Relations before the sale can be finalized. Any required subdivision or survey
fees are the responsibility of the applicant.
5. I/We acknowledge that I am / we are purchasing the above noted lands free and clear of all encumbrances
save and except for such restrictive covenant and subject to the reservations as contained in The Provincial
Lands Act.

Dated at , this of , 20

Signature of Applicant Witness Printed Name Witness Signature

Signature of Applicant Witness Printed Name Witness Signature

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