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Roading Request Form
(*) Denotes that these fields are required to be be filled in before the application can be submitted.
Please Note: Fees may apply please see the current Fees and Charges document for further information.
Definitions:
ROAD CLOSURE REQUEST - Any work that is to be carried out in the road reserve which entails the road to be closed.
ROAD OPENING REQUEST - Excavations in the road, footpath, berm/verge or road reserve including all network utility operators.
VEHICLE CROSSINGS URBAN & RURAL - New entranceways or alterations.
EVENT REQUESTS - Parades, fun runs, market days and/or any sporting events that utilises any part of the road or footpath which may entail the closing of the entire road.
Please tick appropriate box (*)
Road Closure Request
Road Opening Request
Vehicle Crossings Urban & Rural
Event Request
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To the Roading Department:
I/we wish to carry out the work described in the plans and specifications herewith and/or as described below.
Contact Details:
(a) Principal Full Name (*)
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(a) Principal Phone Number (*)
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(a) Principal Email Address
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If Event Request is chosen please indicate the name of the event
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(b) Contractor Full Name (*)
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(b) Contractor Phone Number (*)
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Work Type: (*)
Service Connection (separate connection application is required - Stormwater, Water and Wastewater)
Major
Minor
Emergency
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Details of Work or Event: (*)
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Street Name and Number: (*)
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Town: (*)
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Estimated Start Date: (*)
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Estimated Finish Date (*)
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Location in Street: (*)
Berm/Verge
Footpath
Roadway
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Site Plan (if yes please attach - see below)
Yes
No
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Please attach site plan
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Traffic Management Plan (if yes please attach - see below)
Yes
No
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Please attach Traffic Management Plan
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Surface Reinstatement carried out by: (*)
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The Principal, Network Utility Operator or Contractor remains responsible for rectifying any defects in the trench reinstatement for a period of 12 months after the surfacing is completed.Note: This notification refers to all work within legal road reserve.
I have read and fully understand the implications of the preceeding paragraph (*)
Yes
No
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Full Name
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Date (*)
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