Address
Zip/Postal Code
Affiliation
Name
Affiliation
Beneficiary
City
E-Mail
Fax
Work Phone
Home Phone
Cell Phone
Name
Province/Territory
SECTION 1 APPLICANT INFORMATION
SECTION 3 PERMIT TYPE, PERMIT CLASS and ACTIVITY TYPE
Please provide the names and affiliations of all others in your party. Attach a current résumé or statement of qualifications for all
co-investigators and technical support personnel. Please identify all team members who are Beneficiaries under the Nunavut
Land Claims Agreement.
Please identify the type and class of the permit being requested, along with the associated activity type. For applications for
tourism purposes, please select Class 1.
Permit Class:
Permit Type:
Activity Type:
PERMIT YEAR
Archaeology and Palaeontology
PERMIT APPLICATION FORM
Page 1
Page 2
Indicate the most recent year for which you held a Nunavut archaeology or palaeontology permit (if any):
SECTION 4 PROJECT INFORMATION
Project Title
Provide a summary of your proposal using only the space below and on the following page. Attach a map of the proposed
study area to your application. The proposal summary must provide a clear statement of the aims and objectives of the project, the
field and laboratory research methodology, and the potential scientific and public benefits. If the application is related to a tourism
initiative (e.g., cruise ship) detailed information including a trip itinerary and the estimated number of participants must be provided.
Please Note: Permit applications are translated into the Inuit language - please avoid the use of technical language or jargon.
Page 3
Geographic Area of Project:
Region
NTS Map Reference
Air Photo Reference
Datum
Latitude
Longitude
E:
N:
Zone:
Land Title
Project Budget
Funding Agency*
Page 4
Research and Analysis Schedule:
*Attach a copy of the contract if the fieldwork described in this application is being undertaken through a contractual agreement.
For applications for tourism purposes, the budget and funding fields can be left blank.
Indicate the proposed dates for field work or site visitation. Class 2 applicants should also include anticipated analysis dates.
Field Work (Start)
Analysis (Start)
Total person-days in field:
Analysis (End)
Field Work (End)
SECTION 5 CONSULTATIONS
Land Owner
Applicants must consult with landowners or with other stakeholders concerning proposed field research or site visitation. Letters
should be sent to the Mayor or the Hamlet Council, or to other local agencies such as Hunters and Trappers Associations. Copies of
all correspondence with the relevant Government, Land Claims agency, or individual property owner(s) must be attached to the
permit application. Contact addresses are listed in the Nunavut Archaeology and Palaeontology Permit Guidelines. If the landowner
is being contacted on your behalf by a client, please indicate.
Client is contacting land owner(s) on behalf of applicant - please summarize:
U.T.M.
Page 5
Community
Applicants must inform and consult with communities about their proposed research. Provide the details of your consultations
concerning the proposed research project, and attach copies of your correspondence to the application.
Community Agency Contacted
Contact Name
SECTION 6 COLLECTIONS AND CONSERVATION
Name
Affiliation
Address
Telephone
Fax
E-mail
Applicants must provide the name, affiliation and contact information of the conservator that has been consulted and retained
to provide conservation services for the collections to be made under the proposed research project.
Indicate the project budget allocation for conservation:
Describe the anticipated types of materials to be collected:
Indicate where the collections will be housed for analysis prior to their return to the designated respository:
Name
Location
Temporary Repository
Page 6
List the locations, if applicable, of other institutions where specialists will undertake analysis of sub-samples of the collections:
Other Research Institutions
Name
Location
Name
Location
SECTION 7 LAND USE AND ACCESS TO INUIT OWNED LANDS PERMIT INFORMATION
Depending on the scale of the project, researchers working on Federal Crown Lands may require a Land Use Permit. For information
contact:
Land Resources
Indian and Northern Affairs Canada
P.O. Box 100
Iqaluit, NU X0A 0H0
Telephone (867) 975-4283
Fax (867) 975-4286
Researchers working on Inuit Owned Lands (IOL) may require an Access to Inuit Owned Lands Permit issued by the Regional Inuit
Association. For information contact the Land Manager located in the appropriate region:
Qikiqtani Inuit Association Kivalliq Inuit Association Kitikmeot Inuit Association Makivik Corporation
Regional Land Manager Regional Land Manager Regional Land Manager Regional Land Manager
P.O. Box 1340 P.O. Box 340 P.O. Box 360
Iqaluit, NU X0A 0H0 Rankin Inlet, NU X0C 0G0 Cambridge Bay, NU X0E 0E0
Telephone (867) 975-8400 Telephone (867) 645-2810 Telephone (867) 982-3310
Fax (867) 979-3238 Fax (867) 645-3855 Fax (867) 982-3311
If you already hold a valid Land Use Permit or Certificate of Exemption please provide the permit or certificate number:
Land Use Permit
Certificate of Exemption
Number
Authorization
Date
Applicant Signature
I agree to comply with the provisions of the Nunavut Archaeological and Palaeontological Sites Regulations, the Nunavut
Archaeology and Palaeontology Permit Guidelines, and all terms and conditions of the permit issued pursuant to this application.
SECTION 8 DECLARATION
Page 7
SECTION 9 APPLICATION CHECKLIST
Enclosed
Required
N/A
Curriculum Vitae (new applicants only)
Research Project Description
Map of Study Area
Land Owner Consultation Documents
Community Consultation Documents
Submitting Applications
The deadline for applications is March 31. Applications may be submitted electronically to chpermits@gov.nu.ca; this form may
also be printed and mailed, or sent via fax, to the Territorial Archaeologist at:
Heritage Division
Department of Culture and Heritage
Government of Nunavut
P.O. Box 310
Igloolik, NU X0A 0H0
Tel. (867) 934-2040
Fax (867) 934-2047
PLEASE NOTE: All applications must be signed by the applicant.
Print Form
Submit by Email
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