Gravel Request

<form-template>
	<fields>
		<field type="paragraph" subtype="p" label="January 2 2025 Full guidelines for gravel sales and distribution are set out in policy M-14 Gravel Sales and Distribution.  Guidelines on gravel donations can be found in policy M-15 Gravel Donation.  To request gravel you must be a rate payer of the County of Warner.  Requests must be made by May 15th of the current year. (Please note that this form will be taken off the website after May 15th, no requests will be accepted until January of the following year)." class="paragraph"></field>
		<field type="text" subtype="text" required="true" label="Name" placeholder="First, Last name" class="form-control text-input" name="text-1735053230250"></field>
		<field type="date" required="true" label="Todays Date" description="YYYY-MM-DD" class="form-control calendar" name="date-1735053260129"></field>
		<field type="text" subtype="text" required="true" label="Phone Number" placeholder="Phone Number" class="form-control text-input" name="text-1735053299029"></field>
		<field type="header" subtype="h2" label="Billing Address" class="header"></field>
		<field type="text" subtype="text" required="true" label="Box Number" placeholder="Box Number" class="form-control text-input" name="text-1735053405361"></field>
		<field type="text" subtype="text" required="true" label="Town" placeholder="Town or Village" class="form-control text-input" name="text-1735053443105"></field>
		<field type="text" subtype="text" required="true" label="Province" placeholder="Province" class="form-control text-input" name="text-1735053465134" value="Alberta"></field>
		<field type="text" subtype="text" required="true" label="Postal code" placeholder="Postal Code" class="form-control text-input" name="text-1735053490395"></field>
		<field type="text" subtype="email" required="true" label="Email" placeholder="Email" class="form-control text-input" name="text-1735053517831"></field>
		<field type="header" subtype="h2" label="Gravel Information" class="header"></field>
		<field type="radio-group" required="true" label="Quantity- Number of Tonnes" class="radio-group" name="radio-group-1735053570330">
			<option value="25" selected="true">25</option>
			<option value="50">50</option>
		</field>
		<field type="radio-group" required="true" label="Delivery Type Requested" class="radio-group" name="radio-group-1735053622943">
			<option value="Spread" selected="true">Spread</option>
			<option value="Placed in a Pile">Placed in a Pile</option>
		</field>
		<field type="text" subtype="text" required="true" label="Rural Address Number" description="Blue yard sign on your lane way" placeholder="Rural Address Number" class="form-control text-input" name="text-1735053678534"></field>
		<field type="header" subtype="h3" label="Legal Land Description" class="header"></field>
		<field type="radio-group" required="true" label="Quarter" class="radio-group" name="radio-group-1735053736040">
			<option value="NE" selected="true">NE</option>
			<option value="NW">NW</option>
			<option value="SE">SE</option>
			<option value="SW">SW</option>
		</field>
		<field type="text" subtype="text" required="true" label="Section" placeholder="Section" class="form-control text-input" name="text-1735053788069"></field>
		<field type="text" subtype="text" required="true" label="Township" placeholder="Township" class="form-control text-input" name="text-1735053808299"></field>
		<field type="text" subtype="text" required="true" label="Range" placeholder="Range" class="form-control text-input" name="text-1735053828277"></field>
		<field type="text" subtype="text" required="true" label="Meridan" placeholder="Meridian" class="form-control text-input" name="text-1735053852019" value="W4"></field>
		<field type="paragraph" subtype="blockquote" label="Applicants must be a rate payer of the County of Warner and have must have a residence. Gravel entitlements are up to 50 Tonnes per land owner residence per year to a maximum of 3 residences (150 Tonnes).   Please ensure requests are either 25, 50 Tonnes. Hold harmless agreements must be signed, If you already have a signed agreement please note on form. Hold Harmless agreements can be found on the County of Warner No.5 website.     Applications must be made by May 15th of the current year.    " class="paragraph"></field>
		<field type="radio-group" required="true" label="Completed Hold Harmless Agreement" class="radio-group" name="radio-group-1735053920696">
			<option value="Yes" selected="true">Yes</option>
			<option value="No">No</option>
		</field>
	</fields>
</form-template>

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