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2. Land Owner Information
4. Name:*
5. Mailing Address:*
7. City/Town:*
8. Postal Code:*
9. Telephone:*
11. Card Request Type:*

    1. New
    2. Replacement
    3. Additional Card
13. Resident of:*

    1. County of Wetaskiwin
    2. Argentia
    3. Crystal Springs
    4. Grandview
    5. Ma Me O Beach
    6. Norris Beach
    7. Poplar Bay
    8. Silver Beach
15. Legal Land Description: (One must be chosen or application may be denied)
17. Quarter:
18. Section:
19. Township:
20. Range:
22. Meridian:
    -- Select One --4th5th
24. OR
26. Plan:
27. Lot:
28. Block:
30. Additional Card Holder Name (Fees Apply)
32. Terms and Conditions:
    • The card holder must be a landowner of the County of Wetaskiwin or a resident of an approved municipality eligible for access to the transfer station sites.
    • The card holder must scan the card to gain admittance to the transfer station site. In the case of a lost card, the original card will be cancelled, and a new card will be issued at the cost as per the Fees and Charges Bylaw.
    • The card holder and any of their authorized card users, will agree to abide by the Solid Waste Management Policy, Bylaws and any revision that may be made by the County, provided that the policy and/or procedure is not in contravention of any regulatory act.
    • The card holder and their authorized card users will be subject to load audits and waste screening at any of the County of Wetaskiwin Transfer Station sites and agree that any waste delivered to and deposited at the transfer station sites is acceptable under A.E.P. Regulations (Alberta Environment Protection Act, Waste Control Regulation).
    • The card holder or authorized card user agrees to be responsible for any charges associated with the scanned transactions at the transfer station site.
    • The card holder or authorized card user hereby indemnifies and save completely harmless against all actions, proceedings, claims, fines, demands, losses, debts, costs, damages and expenses which may be brought forth to the County of Wetaskiwin.
    • The card holder and their authorized card users must always abide by the Highway Traffic Act and other regulation governing the equipment and site attendants there of including the County of Wetaskiwin’s policies relating to this item, while on site.
    • The County of Wetaskiwin hereby reserves the right to make changes to its policies and forms including this application from time to time without prior notice.
    • The completion of this form does not in any way directly authorize the shipment of waste to the County of Wetaskiwin Transfer Station sites; the County reserves the right to withdraw all rights given under this agreement at any time without prior notice.
    • By commencing use of the County of Wetaskiwin Transfer Station sites, the card holder shall have agreed to the terms, conditions, policies and bylaws.
34. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, and 2) by signing in this alternate manner, your electronic signature is valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    I, the landowner agree to be responsible for any actions or charges associated with the card issued to the above Legal Land Description until the said property is sold or a written request to cancel the card is submitted.

36. Consent:

    1. I consent

38. 1. The personal information on this form is collected under the authority of Section 33 (c) of the Alberta Freedom Of Information And Protection Of Privacy Act . The information will be used to process your application(s) and your name and address may be included on reports that are available to the public. If you have any questions on the collection and use of this information, please contact the FOIP Coordinator at (780) 352-3321. All pertinent information included in a written submission received from the public that is presented to a Council, Committee or Board meeting of the County of Wetaskiwin becomes part of the public meeting minutes, unless otherwise requested by the individual in writing. Any personal information pertinent to the issue (including but not limited to, name and legal land description) could be recorded in the public minutes of the meeting. 

40. Office Use Only:
42. Roll #
43. Owner #
44. Date Paid:
45. Amount Paid:
47. Approved by:
48. Date Card Issued:
Leave This Blank:


50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit

* indicates a required field