Blasting and Rock-breaking Regulation Bylaw No. 619-2023
Belcarra, British Columbia
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VILLAGE OF BELCARRA
SCHEDULE "A" TO BLASTING REGULATION BYLAW NO. 619, 2023
APPLICATION FOR A BLASTING PERMIT OR ROCK-BREAKING PERMIT
1.
Date: _________________________________
2.
This application is for a (check one)
Blasting Permit
Rock Breaking Permit
3.
I, __________________________________________, of
(Print full name of Owner)
________________________________________
_____________________
(Address)
(Daytime Phone)
am the registered Owner of the following lands:
________________________________________________________________________
(street address)
________________________________________________________________________
(legal description)
4.
I hereby authorize _________________________________________________________
(Print full name of Owner's Agent)
of _____________________________________________
_________________
(company name)
(phone no.)
to act as my agent pursuant to this bylaw.
5.
The purpose of the blasting and the rock removal is (check all relevant)
road and utilities
utility connections
house or garage
coach house
power pole
driveway or parking area
other (describe)
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Village of Belcarra Blasting Regulation Bylaw No. 619, 2023
Schedule "A" - Application for a Blasting Permit or Rock-breaking Permit
Page 2 of 4
6.
Estimated total volume of rock to be Blasted ________________________m3
7.
Expected date of starting of drilling _____________________________________
8.
Estimated start date of Blasting ________________________________________
9.
Estimated end date of Blasting ________________________________________
10.
Estimated start date of On-Site Processing of Blast Rock ____________________
11.
Estimated end date of On-Site Processing of Blast Rock _____________________
12.
The fee as required by the Village of Belcarra Fees and Charges Bylaw is enclosed.
13.
The following documentation is provided in support of this application:
a)
a completed and signed Application;
b)
a title search conducted within the past 30 days for the property where the Blasting is
to occur;
c)
a copy of a valid Blaster's Certificate issued to the Blaster by WorkSafe BC for all
persons completing the Blast (the original of which must be produced for inspection if
required by the Building Official);
d)
an Indemnification Form executed by the Owner, which will at a minimum provide
that the Owner will:
i.
indemnify and defend the Village from all claims and damages related to or
arising from the Blasting;
ii.
waive all claims for contribution and indemnity against the Village for losses
related to or arising from the Blasting; and
iii.
pay for all damage that results to third party structures and property as a result
of the Blasting.
e)
a certificate of insurance acceptable to the Building Official in the minimum amount
of $5,000,000 naming as named insureds the Blaster, the Owner, and the Village
providing defense and indemnity protection against all liability for property damage
or personal injury arising from or relating to the proposed Blasting;
f)
a completed Assurance Form;
g)
a Blasting Plan that is prepared by or under the supervision of the Blasting Engineer
that must include, without limitation, (i) a diagram of the blasting pattern; (ii) a plan
indicating the full extent of the Blasting Area; (iii) the sequence of detonation and the
maximum weight of explosives to be detonated per delay; (iv) the specific safety
measures to be taken; (v) the specific measures taken to minimize the effect of the
Blasting on third parties; (vi) Maximum Peak Particle Velocity and Frequency
Response; (vii) area requiring notification to Neighbouring Owners; (viii) the Pre-Blast
Inspection Area; and (ix) Placement of Blasting signage; (x) Test blasting
requirements; (xi) Pre-blast survey radius; (xii) Drill log records; (xiii) Rock removal
and (xiv) work sequence.;
Village of Belcarra Blasting Regulation Bylaw No. 619, 2023
Schedule "A" - Application for a Blasting Permit or Rock-breaking Permit
Page 3 of 4
h)
a plan indicating the Blast Area;
i)
a plan indicating the Pre-Blast Inspection Area, and should this area be less than
100 meters from the edge of the Blast area, the Blasting Engineer must provide
justification for the reduction;
j)
a Control Measures/Blasting Plan, prepared by the Blaster and accepted by the
Registered Professional Engineer, which shall consist of a sketch of the blasting
pattern and include the sequence of detonation and the maximum weight of
explosives to be detonated per delay and shall specify measures designed to
minimize potential injury to any person and avoid, control, or minimize the impact
of the Blasting. If Blasting is not proposed within 150 meters of any structure,
utility line, railway, public or private road, street, lane, driveway, or walkway, or is
not expected to produce a rock cut over 3.5 metres high, then the Building Official
may waive the requirement for a Control Measures/Blasting Plan. During the
continuance of the permit, the Building Official may authorize amendments to the
Control Measures/Blasting Plan which are approved in writing by the Registered
Professional Engineer.
k)
a report from the Blaster detailing how drill rigs and compressors are to be
muffled, note the Building Official may require use of equipment or techniques
to reduce or control noise and dust levels;
l)
a description of any On-Site Processing of Blast Rock that is to occur including
the how noise and dust is to be controlled and a schedule for the processing
work, note the Building Official may require the use of equipment or techniques
to reduce or control noise and dust;
m)
a description of the purpose of the Blasting;
n)
the schedule for Blasting and any planned On-Site Processing of Blast Rock
prepared in a manner that will minimize the duration of the impacts of noise and
dust to the adjacent areas, note the Building Official may alter the schedule to
minimize the impact to the Neighbouring Owners;
o)
a statement of the amount of material that is proposed to be removed;
p)
a report on where and how notice of Blasting, the Pre-Blast Inspections, the
procedure to be used to notify Neighbouring Owners and the steps a
Neighbouring Owner is to take in the event that Blasting causes any damage to
land or buildings on the land;
q)
the name and contact information for the Blasting Engineer;
r)
the name and contact information for the Registered Professional Engineer; and
s)
the permit fee and damage deposit as set out in the Fees and Charges Bylaw. The
damage deposit shall be security for all requirements under this Bylaw and may
be used at any time by the Village to secure completion of any of these
requirements. A permit extension fee will be required for all permits that exceed
their permit expiry date as determined by subsection 3.1.3. Extension will be
granted from permits based on the discretion of the Building Official.
Village of Belcarra Blasting Regulation Bylaw No. 619, 2023
Schedule "A" - Application for a Blasting Permit or Rock-breaking Permit
Page 4 of 4
14.
The information provided in Schedule "A" is certified to be correct:
___________________________________________
(Owner's name(s)
__________________________________________________________________
(Owner's signature(s) or Authorized Signatory if a Corporation)
_____________________________________
(Date)
_________________________________________________________________
(Owner's Agent's Signature)
______________________________________
(Date)
The Village of Belcarra is collecting personal information in accordance with Section 26(c) of the Freedom of Information and
Protection of Privacy Act. The personal information collected on this form is collected for the purposes of processing a Blasting or
Rock-Breaking permit and for administration and enforcement. Questions about the collection, use and disclosure of this
information can be directed to the City's Privacy Officer at Village of Belcarra, 4084 Bedwell Bay Road, Belcarra, BC V3H 4P8.
Phone 604-937-4100 or email [email protected]
SIGN
VILLAGE OF BELCARRA
SCHEDULE "B" TO BLASTING AND ROCK-BREAKING REGULATION
BYLAW NO. 619, 2023
INDEMNIFICATION FORM
1.
Date: _________________________________
To:
The Building Official
The Village of Belcarra
4084 Bedwell Bay Road
Belcarra, BC
V3H 4P8
Re:
______________________________________________________________________
(Address or Description of Project Location)
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
The Owner hereby agrees to indemnify and defend the Village of Belcarra 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 or
Rock-breaking and related activities on the above referenced property or location for which a
Blasting Permit or a Rock-Breaking Permit is applied for pursuant to Blasting and Rock-
Breaking Regulation Bylaw No. 619, 2023 including without limitation any acts or omissions of
the Owner, the Blasting Engineer, the Blaster, the undersigned agent or the employees and
agents or 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.
_______________________________________________________
(Owner's name(s)
_______________________________________________________
_________________
(Owner's signature(s) or Authorized Signatory if a Corporation)
(Date)
_______________________________________________________
_________________
(Owner's Agent signature)
(Date)
The Village of Belcarra is collecting personal information in accordance with Section 26(c) of the Freedom of Information and
Protection of Privacy Act. The personal information collected on this form is collected for the purposes of processing a Blasting or
Rock-Breaking permit and for administration and enforcement. Questions about the collection, use and disclosure of this
information can be directed to the City's Privacy Officer at Village of Belcarra, 4084 Bedwell Bay Road, Belcarra, BC V3H 4P8.
Phone 604-937-4100 or email [email protected]
SIGN
SIGN
VILLAGE OF BELCARRA
SCHEDULE "C" TO BLASTING AND ROCK-BREAKING REGULATION
BYLAW NO. 619, 2023
ASSURANCE FORM
CONFIRMATION OF COMMITMENT BY OWNER AND BY BLASTING ENGINEER
1.
Date: _________________________________
To:
The Building Official
The Village of Belcarra
4084 Bedwell Bay Road
Belcarra, BC
V3H 4P8
Re:
Verification of Control Measures/Blasting Plan and Monitoring of Blasting by a Blasting
Engineer at:
______________________________________________________________________
(Address or Description of Project Location)
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Dear Sir:
The undersigned Owner has retained ___________________________as a Blasting Engineer
to review a Control Measures/Blasting Plan and to monitor the Blasting as required by Blasting
and Rock-breaking Regulation Bylaw No. 619, 2023 (the "Bylaw").
The Owner and the Blasting Engineer have read the Bylaw. The Owner and the Blasting
Engineer acknowledge their responsibilities to each other and to notify the Building Official if the
Blasting Engineer ceases to be retained by the Owner either before the date the Blasting
Engineer ceases to be retained or, if that is not possible, then as soon possible.
The Owner and the Blasting Engineer understand that where the Blasting Engineer ceases to
be retained at any time during the project, Blasting and related work on the above project will
cease until such time as:
a)
a new Blasting Engineer is retained, and
b)
a new letter in the form set out in Schedule "C" to Blasting and Rock-breaking
Regulation Bylaw No. 619, 2023 is filed with the Building Official.
Village of Belcarra Blasting and Rock-breaking Regulation Bylaw No. 619, 2023
Schedule "C" - Assurance Form
Page 2 of 2
The Blasting Engineer hereby gives assurance that the Blasting Plan reviewed by this
registered professional in support of the application for the Blasting Permit substantially
complies with Blasting and Rock-breaking Regulation Bylaw No. 619, 2023 and other applicable
enactment's respecting safety and meets all reasonable criteria for safety of life and property
and will provide the further written assurance required by Section 3, and Section 5.6 of Blasting
and Rock-breaking Regulation Bylaw No. 619, 2023.
The Blasting Engineer hereby undertakes to be responsible for field reviews of the Blasting and
all other obligations required in the Bylaw.
The Blasting Engineer also undertakes to notify the Building Official in writing as soon as
possible if the Blasting Engineer's contract for field review is terminated at any time.
The undersigned Blasting Engineer certifies that he or she is licensed to practice as a registered
professional engineer under the Engineers and Geoscientists Act of B.C. and is specialized in
rock mechanics.
Registered Professional
Owner
________________________________________ _________________________________
Registered Professional's Name (print)
Owner's Name (print)
________________________________________ _________________________________
(Registered Professional's Signature)
(Owner's or Owner's appointed agent's
signature (If Owner is a corporation the
signature of a signing officer must be given
here)
________________________________________
(Address)
________________________________________
________________________________________
(affix Registered Professional's Seal above)
If the Registered Professional is a member of a firm, complete the following:
I am a member of the firm:
_____________________________________________________________
(Name of firm) and I sign this letter on behalf of the firm.
The Village of Belcarra is collecting personal information in accordance with Section 26(c) of the Freedom of Information and
Protection of Privacy Act. The personal information collected on this form is collected for the purposes of processing a Blasting or
Rock-Breaking permit and for administration and enforcement. Questions about the collection, use and disclosure of this
information can be directed to the City's Privacy Officer at Village of Belcarra, 4084 Bedwell Bay Road, Belcarra, BC V3H 4P8.
Phone 604-937-4100 or email [email protected]
VILLAGE OF BELCARRA
SCHEDULE "D" TO BLASTING AND ROCK-BREAKING REGULATION
BYLAW NO. 619, 2023
BLASTING AND ROCK-BREAKING PERMIT
BLASTING PERMIT NO. ___________
ROCK-BREAKING PERMIT NO. ____________
This permit authorizes the Blaster working for the Owner
Blaster
Owner
_______________________________________
_________________________________
(Blaster's Name)
(Owner's Name)
_______________________________________
(Blasting Firm)
_______________________________________
__________________________________
(Address)
(Address)
_______________________________________
__________________________________
(Daytime phone number)
(Daytime phone number)
To Blast at the following location:
___________________________________________________________________________
(Address or Description of Project Location)
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
for a period of _____calendar days from the date of issue of this Blasting Permit in accordance
with:
Blasting Engineer Name: _______________________________________________________
Daytime contact #: _________________________
Registered Professional Engineer Name: ___________________________________________
Daytime contact #: ________________
Village of Belcarra Blasting And Rock-breaking Regulation Bylaw No. 619, 2023
Schedule "D" - Blasting Permit
Page 2 of 2
Changes from the specifications referred to in the application are listed below and are part of
this Permit:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Permit Approved: _______________________________ Date of Permit: ________________
Building Official
Extension Approved: _____________________________ Date of Extension: ______________
Building Official
The Village of Belcarra is collecting personal information in accordance with Section 26(c) of the Freedom of Information and
Protection of Privacy Act. The personal information collected on this form is collected for the purposes of processing a Blasting or
Rock-Breaking permit and for administration and enforcement. Questions about the collection, use and disclosure of this
information can be directed to the City's Privacy Officer at Village of Belcarra, 4084 Bedwell Bay Road, Belcarra, BC V3H 4P8.
Phone 604-937-4100 or email [email protected]