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Snapshot 40faf4df791f · verified 2026-09-24 ·
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unofficial consolidation, the official version is held by the municipal clerk.
MLA Planning Region
PERMIT APPLICATION FORM
Municipality:
Roll #:
Name of Applicant:
Mailing Address:
Email Address:
Phone Number:
Name of Owner: (If diƯerent from applicant)
Mailing Address:
Signature of Owner:
Date:
Legal Description:
¼:
(sec)
(twp)
(rge)WPM
Lot:
Block:
Plan:
Civic Address:
Property Size: (fill in all that applies) Acres:
Frontage:
SQFT:
Other:
Description of Project:
NOTE: If applying for a farm building, please complete and submit a farm building declaration form.
Specifications: Length:
Width:
Height:
Total SQFT:
Other:
Valuation of Project:
Materials $
+ Labour $
=Total $
(Please include a value even if you are completing some or all the work yourself)
Contractor:
Mailing Address:
Phone Number:
Email:
Architect/Engineer/Designer:
Phone Number:
Mailing Address:
Email:
Site Plan Included
Construction Plan Included
Engineered Drawings Included (if required)
Submit completed application to: mlaplanningregion@gmail.com or mail to
MLA Planning Region, Box 574 Dauphin, MB R7N 2V4
APPLICANT/OWNER INFORMATION
PROJECT INFORMATION
PERMIT APPLICATION CHECKLIST
SIGN