Current Page 1 Page 2 Preview Personal information on this form is collected under section 31(c) of the Freedom of Information and Protection of Privacy Act R.S.P.E.I. 1988, c.F-15-01 as it relates directly to and is necessary for the Coastal Hazard Assessment and will be used to administer this program. If you have any questions about this collection of personal information, you may contact the Climate Change division at 902-620-3232. Information may be verified. Identification Please provide your contact information. Business/Organization Name Contact First Name Contact Last Name Address 1 Address 2 City, Town, or Community Province Postal Code For example C1B 0X1 or 12345 Country Telephone 1 For example 902-555-5555 Telephone 2 For example 902-555-5555 Fax Number For example 902-555-5555 Email Address Would you like the completed Coastal Hazard Assessment sent to you by email or mail? If you choose email, you must provide an email address in the field above. - Select -EmailMail What is the reason for your request? - Select -I am the registered owner of the property.I am (or I represent) a prospective buyer of the property.I represent the municipality that the property is located in.I am conducting research.I am applying for a development permit.I am applying to subdivide the property.I am applying for funding and the CHA information is required.Other Other Reason If you would like a copy of your completed CHA sent to a third party (ie municipality, Provincial Planning department, funding agency), provide the additional email address: Is your mailing address the same as what you entered in the fields above? - Select -YesNo Mailing Address Address City, Town, or Community Postal Code For example C1B 0X1 or 12345