Notification of Elevator Construction or Renovation
A.
Company Information
Company name as registered or incorporated: _______________________________________________________________
Head office: __________________________________________________________________________________________
Mailing address (if different from above): ___________________________________________________________________
Telephone no.: __________________________________
Website: ____________________________________________
Email:_______________________________________________________________________________________________
B.
Details of Construction
or Renovation
(please check one)
Location of elevator: _________________________________
Type of construction:
Concrete
Tentative date of completion: ________________________
Wood
Steel bins
No. of steel bins _______________
If it is a renovation, briefly explain: ________________________________________________________________________
____________________________________________________________________________________________________
Are annexes attached?
Yes
No
Is condominium storage provided?
Yes
No
If so, how are annexes attached? _________________________________________________________________________
C.
Facility Information
Grain Storage Capacity
Capacity (tonnes)
Year built
Cleaner
Yes
Principal elevator
No
Dryer
Yes
No
Condominium storage
Annex
Annex
Annex
Annex
Total capacity
Scale Capacity
Is scale work involved in construction/renovation?
No.
Capacity (tonnes)
Yes
No
Hopper, Platform, or Overhead
Date scales last inspected
(Day/Month/Year)
Receiving
Shipping
Receiving/Shipping
Revised May 2013
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D.
Statutory Declaration
This construction/renovation is made in accordance with the Canada Grain Act. The details given must be correct. If the
Canadian Grain Commission (the Commission) discovers, subsequent to the granting of the licence, that wrong information
has been supplied, the Commission may revoke the licence.
In the matter of this notification of elevator construction/renovation.
To Wit:
I ______________________________________ of the ______________________________________________________
Of _____________________________________ in the province of _____________________________________________
do solemnly declare that the answers given in this notification of elevator construction/renovation are correct to the best of my
knowledge and belief.
_______________________________________________________
Print name
_________________________________________________________________
Title
_______________________________________________________
Signature
_________________________________________________________________
Date (Day/Month/Year)
Please submit this application in electronic format to:
licence@grainscanada.gc.ca
Revised May 2013
If you are unable to submit electronically, this
application can be mailed to:
Canadian Grain Commission
Licensing Program
601-303 Main Street
Winnipeg, MB R3C 3G8
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