Application for Blasting Permit

District of Lake Country

10150 Bottom Wood Lake Road
Lake Country, BC V4V 2M1
t: 250-766-6674 f: 250-766-0200
lakecountry.bc.ca

APPLICATION FOR BLASTING PERMIT

Application # X-Ref #

DESCRIPTION: ENTER TYPE OF PERMIT

Blasting Permits are issued in accordance with Blasting Bylaw 965, 2016. Blasting is defined as the handling,
preparation and usage of explosives. Blasting permits are issued only to blasters, an applicant with a blaster in their
employ or an applicant that has a contract with a blaster. By signature of the application, it is hereby declared that all
statements and information contained in or attached to this application are, to the best of the applicants knowledge
and belief true and correct in all respects. The applicant confirms to have read, understood and abide by all
requirements of Blasting Bylaw 965, 2016.

APPLICATION

APPLICANT INFORMATION
APPLICANT/ NAME: PH#:
AGENT/
ADDRESS:
BLASTING
COMPANY PC: EMAIL: CELL:
NAME: PH#:
REGISTERED
ADDRESS:
OWNER
PC: EMAIL: CELL:

Applicant/Owner/Agent Signature: Date:

BLASTING INFORMATION
Civic address of blasting:
Legal address of blasting:
Site Contact Phone:
Type of Blasting: ☐Driveway ☐ Foundation ☐ Off-site ☐Services ☐ Other
Blaster Name: Blasting Grade: ☐ above ☐ below
Blasting Consultant*: Estimated Start Date:
Blasting Consultant Phone: Probable Duration:
* Blasting Consultant must be independent of the blaster as well as the explosive manufacturer and distributor.
☐ I acknowledge there are no utilities within any easement/right of way which could be affected by the blast.
INDEMNIFICATION
The Owner hereby agrees to indemnify and defend the District of Lake Country and its agents and employees with
respect to all actions, causes of actions, claims, demands, awards, judgments, costs and expenses (including legal
fees) arising from or in any way relating to the blasting and related activities on the above referenced property or
location for which Blasting Permit is applied for pursuant to Blasting Bylaw 965, 2016 including without limitation
and acts or omissions of the Owner, Engineer, the Blaster, the undersigned agent or the employees and agents of
any of them. The Owner further undertakes to pay for any and all damage that results to third-party structures and
property as a result of the blasting. The District of Lake Country will assume no responsibility for any errors of the
Blasting Consultant.

I hereby authorize the above–named OFFICE USE ONLY Date Initials

applicant to act as my agent on this application. Application Complete ☐
Consultant Approved ☐
OWNER’S NAME (PLEASE PRINT) Application Fees Paid ☐
Permit issued ☐
CALCULATION OF NON REFUNDALBLE FEES
OWNER’S SIGNATURE
☐ Application fee (10-1430-0010) $150.00
________________________________________ ☐ Certificate of Title Search (10-1460-0015) $15.00
DATE TOTAL PAYABLE
 APPLICATION FOR BLASTING PERMIT
CHECKLIST: WHAT TO INCLUDE WITH YOUR APPLICATION

 BLASTING CERTIFICATE ISSUED BY WORKSAFE BC


PAYMENT OF APPLICATION FEE


CURRENT CERTIFICATE OF TITLE FOR THE SUBJECT LANDS (within the last 90 days)
A title search may be purchased through the District for fee and must include all relevant land title
charges including easements, SROW, DPs or any item registered on title that is applicable.


PRE-BLAST SURVEY
Be sure to complete a pre-blast survey as per section 4 of Blasting Bylaw 965, 2016


PROOF OF LIABILITY INSURANCE
Liability insurance in the amount of five million dollars ($5,000,000) naming the District of Lake Country
as co-insured must be provided.

 OWNER AUTHORIZATION
Be sure the owner has signed the front of this sheet.

www.lakecountry.bc.ca
 Blasting Permit Guidelines
District of Lake Country
10150 Bottom Wood Lake Road
Lake Country, BC V4V 2M1
t: 250-766-5650 f: 250-766-2903
lakecountry.bc.ca

APPLICATION FOR BLASTING PERMIT

The Applicant must be a Blaster, have a Blaster in their employ or have a contract with a Blaster for the works. The
Applicant must identify a Blasting Consultant that is independent of the Blaster, the explosive manufacturer and
the distributor.

☐ Complete a Blasting Permit Application Form which must include the following:
☐ Blasting Certificate issued by WorkSafeBC
☐ Payment of Application Fee ($150.00)
☐ Certificate of Title
☐ Pre-Blast Survey (Section 4 of Blasting Bylaw 965, 2016)
☐ Proof of liability insurance in the amount of five million dollars ($5,000,000) naming the District of Lake
Country as co-insured

PRE-BLAST SURVEY
A Pre-Blast Survey must include:
☐ A project description and details of the Blasting
☐ The location of the Blasting
☐ The Blaster’s name and contact information
☐ The Pre-Blast Surveyor’s name and contact information
☐ The approximate start and completion date for the Blasting
☐ Details of all structures on all properties within the anticipated area of impact (“Affected Community”) as
determined by Blasting Consultant including:
o Details of structures inspected and the effect of Blasting on those structures;
o Details of structures not inspected, why they were not inspected and the effect of Blasting on those
structures; and
o High-quality visuals of the exteriors and interiors of all structures.
☐ Details of all landscape features, infrastructure and works within the Affected Community and the effect of
Blasting on them
☐ Written confirmation that all owners of lands within the Affected Community were contacted and notified
of the proposed Blasting and if not contacted, the reasons why
☐ Written confirmation of Owner approval of the Pre-Blast Survey
☐ Written confirmation of notice given to Affected Community at least 14 days prior to Blasting

A Pre-blast survey must:

☐ be attached to permit application
☐ be given to and approved by the Owner of the site
☐ be approved by the District Engineer or designate
☐ be maintained by the Blasting Consultant for at least one year following the completion of Blasting
NOTIFICATION OF BLASTING TO AFFECTED COMMUNITY
Written notice and a copy of the Blasting Permit must be:
☐ Posted on a sign at the site and
☐ Delivered to all property owners within the Affected Community (personally or by registered mail) at least
seven (7) days prior to Blasting.
Notice must include the following:
☐ The name of the person responsible for Blasting including their telephone number;
☐ The intended start date, time and expected duration of the Blasting; and
☐ The location of the Blasting site.

The Blasting Consultant may also require notice be given to the senior administrator of any school, hospital, or
health care facility in the vicinity of the Affected Community at least two hours prior to Blasting.

BLASTING REGULATIONS
1. Blasting is only permitted between 8:30 am and 4:30 pm Monday through Friday, excluding statutory holidays.
2. The Blasting site and any adjacent area affected by the Blasting are to be left in a neat and safe condition.
3. The District Engineer or designate may, by written notice, cancel or suspend any Blasting Permit if they believe
Blasting is being carried on in a dangerous, incompetent, negligent or unsafe manner. The written notice must
be delivered personally or by registered mail to the Applicant or by posting a Stop Work Order. The Blasting
must stop immediately and the permit returned to the District Engineer or designate.

RECORDKEEPING AND SUBMISSION OF RECORDS

During the course of Blasting, the Blasting Consultant must review the records and confirm with the Blaster and
District that Blasting is being carried out in accordance with the specifications of Blasting Bylaw 965, 2016 and
immediately report any problems, unusual circumstances or inconsistencies to the Blaster/District. Blasting
monitoring reports must be submitted to the District Engineer or designate upon request.

At least one recording seismograph must be used for every Blasting when deemed appropriate by the Blasting
Consultant. The Applicant must keep all seismograph records for at least one year following the Blasting and are to
be made available to the District upon request.

INSURANCE
The Applicant must supply the District with liability insurance in the amount $5,000,000 naming the District of Lake
Country as co-insured and providing indemnity for judgments and defense of actions for injuries for loss or damage
resulting from any accident or occurrence for which the Applicant, Applicant's agents, servants and employees may
be liable as the result of the Blasting operations. The policy must not have any Blasting-related exclusion.

FINES
* Early Late
Payment Payment
Description of Contravention Penalty Penalty Penalty
Failure to obtain a permit prior to blasting $500 $250 $625
Failure to utilize blasting consultant $500 $250 $625
Failure to conduct a pre-blast survey on the affected community prior to $500 $250 $625
blasting
Failure to deliver blasting notice to affected community $500 $250 $625
Failure to Monitor $500 $250 $625
Blasting outside of permitted times $500 $250 $625
Obstruction of the District and Blasting Consultant during the enforcement of $500 $250 $625
the Blasting Bylaw
*Bylaws 966 and 967, 2016

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