__________________ Lot _____, Conc. ______, Ward _________
Farm Owner/Operator     Farm Location
County of Prince Edward

A Nutrient Management Plan is being prepared for our _________________ (Type of Livestock) operation. Our goal is to carry out an environmentally sound program. In order to accomplish this, we need more land than we currently own. The proper application of livestock manure, following a Nutrient Management Plan shall be carried out to minimize the impact on the environment.

To register lands in the Nutrient Management Plan of _________________ (Farm Owner/Operator), please complete this form as follows:

I,____________________ (land-owner) give permission to _______________________ (Farm Owner/Operator)

to incorporate my lands in the Nutrient Management Plan of _______________________ (Farm Owner/Operator) and to apply manure on land owned at the following locations:

(If more space is required, please attach a separate list including the same information as requested above.)

The landowner gives permission to the livestock farmer to do soil sampling on the above-noted property(ies) to determine the condition of the soil, as required for the purpose of a Nutrient Management Plan.

The landowner will not give permission to use the land identified above for the application of livestock manure or biosolids (sewage sludge) originating from any other livestock farm or other source during the term of this agreement.

The landowner also agrees that any biosolid or livestock manure application to the land identified above must be incorporated into a Nutrient Management Plan.

The farmer undertakes to notify the County of any changes that affect compliance with this agreement.

This agreement shall be in force for a maximum period of five (5) years or as changes occur, commencing on _________ and ending on __________ .
However, sufficient lead time would be required if plans need to be altered.

Pollution liability insurance will be carried by___________(Farm Owner /Operator) to cover spill cleanup and liability.

The landowner is notified by this agreement that any land owned within the County of Prince Edward will be registered on the County of Prince Edward Geographic Information Systems by the Corporation of the County of Prince Edward.

Pemlission to use these lands for the purposes of a Nutrient Management Plan is required from all property owners listed for the affected lands. For properties owned by more than one person, permission may be given by additional owners in the form of a signature on this form or a signed letter accompanying this form.