NAPTEP Application Form

Extracted text (beginning)

NAPTEP Application Form Revised: May 1, 2023 Page 1 of 4 
   
  
  
  
 
 
 
Natural Area Protection Tax Exemption Program 
APPLICATION FORM 
Please complete and attach the Application Checklist at the end of this form to your application. Be sure to include all required 
information with your application and ensure your site plan is complete and accurate.
 
We can only accept and process complete applications. 
 
 
 
PROPERTY OWNER (Please Print) 
Please list all registered owners as indicated on State of Title Certificate. Add additional page if more than two owners. 
Name Name 
Street Address Street Address 
City Province   
Postal Code Postal Code 
Telephone      Telephone  
OFFICE USE ONLY 
Size of Property   Application Fee   Receipt Number   File Number:   
APPLICANT INFORMATION 
(If different from owner) 
Name Street Address   
 
City
 
Province
  
Postal Code  
 
Telephone 
Cell E-mail 
DESCRIPTION OF PROPERTY 
(As indicated on State of Title Certificate) 
 
Parcel Identifier (PID) 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Legal Description:   
Street Address or General Location    
Jurisdiction and Folio Number (from Property Assessment/Tax Notice) 
Property Size (hectares)    Proposed Covenant Size (hectares)  
Email     
Email     
Cell Phone   
Cell Phone
  
City Province   
   
 
 
 
200 - 1627 Fort Street, Victoria, BC V8R 1H8 
Telephone:
 250-405-5186 Fax: 250-405-5155
Toll Free via Service BC in Vancouver 604-660-2421
Elsewhere in BC 1-800-663-7867
Email:
 itcmail@islandstrust.bc.ca
Website: 
islandstrust.bc.ca/conservancy

NAPTEP Application Form Revised: May 1, 2023 Page 2 of 4 
(1) Why do you want to covenant your land? 
(2) Please describe the current 
use(s) of land and building(s) on the property.
 
 
(3) Please describe the current 
use(s) of land and building(s) on adjacent properties.
 
 
(4) 
Please check as many of the following boxes as necessary to 
indicate the natural features
 on your property that you 
believe 
make it eligible for a Natural Area Exemption Certificate and that the property owner(s) is (are) willing to permanently protect 
through NAPTEP. 
Areas relatively undisturbed by human activity that are good examples of eligible ecosystems (see Islands Trust Act 
NAPTEP Regulations for details) 
Areas relatively undisturbed by human activity that are key habitat for rare native plant species or plant communities 
Areas that are critical habitat for native animal species in relation to breeding, rearing, feeding or staging 
Geological features 
 
(5) If you have additional information, such as photographs, maps, reports, letters from qualified parties or professional 
assessments that support your application for a Natural Area Exemption Certificate, please attach to your application. 
 
(6) 
Site Plan: Please submit a sketch that shows the location 
of the natural features and buildings on the property. 
Reference the attached Application Checklist for 
a list of features to be included on the Site Plan.
 
(7) 
Is your

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