A well licence issued by the Ministry of Natural Resources and Forestry (MNRF) is required to drill, operate, deepen, alter or enter a well, or engage in any activity on or in a well. A complete Application for a Well Licence form must be submitted for review by the ministry, and the Minister may grant a licence. A complete submission includes the following depending on the purpose for the licence: New drill - Application for a Well Licence - Location plan - Drilling program - Application fee Existing well - Application for a Well Licence - Well Location sketch - Drilling program, if well is to be deepened or re-entered - Application fee Plugging - Application for a Well Licence - Well Location sketch - Application fee

Application may only be completed for recipients of ODSP. The following approved health care professionals licensed to practice in Ontario can complete the application: • Physicians, Nurse Practitioners, Registered Nurses, Occupational Therapists, Physiotherapists, Physician Assistants, and Psychologists* *Psychologists can only complete the Medical Transportation section of the form. The application may only be completed for medical supplies, items, and devices listed in the MSN Schedule of Benefits (https://www.ontario.ca/page/ontario-disability-support-program-health-and-disability-benefits) and items must not be otherwise reimbursed or subject to reimbursement from any other source.

This application form is for family members (“applicant”) who have been granted standing at a coroner’s inquest where the deceased was a victim of crime or involved in a police-related incident. The applicant or their legal representative can complete this form to apply for reimbursement of eligible legal fees and expenses under either the Coroner’s Inquest Legal Fee Reimbursement Program or the Coroner’s Inquest Family Reimbursement Program. Please consult the Coroner’s Inquest Legal Fee Reimbursement Program/Coroner’s Inquest Family Reimbursement Program Guideline for information on program eligibility criteria, eligible expenses, and the reimbursement process.