Online Form - Parking Permits - Work Zone Permit Application

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Applicant details

Company name*

Company ABN*

First name*

Last name*

Phone*

Email*

Address

Street Address:*

City:*

State:*

Post Code:*

Country:*

Work location details

Principal’s Indemnity Agreement

Obligation to Insure: The Permit Holder shall at all times during the agreed Term, be the holder of a current Public Liability Policy of insurance (“The Public Liability Policy”) in respect of the activities specified herein in the name of the Permit Holder providing coverage for a minimum sum of $10 million (or more). The Public Liability Policy shall be effected with an insurer approved by the Council.

The Public Liability

The policy shall cover such risks and be subject only to such conditions and exclusions as are approved by the Council and shall extend to cover the Council with respect to claims for personal injury or property damage arising out of the negligence of the Hirer/User/Permit holder.

Council’s Indemnity

The Permit Holder agrees to indemnify and to keep indemnified, the Council, its servants and agents, and each of them from and against all actions, costs, claims, charges, expenses, penalties, demands, and damages whatsoever which may be brought or made or claimed against them, or any of them, in connection with the Permit Holders performance or purported performance of its obligations under the Permit once granted and be directly related to the negligent acts, errors or omission of the Permit Holder.

Request to obstruct*

Road
Verge
Carbay(s)

If obstructing car bays, how many will be obstructed?*

Start date*

Start time*

Finish date*

Finish time*

Nature of works*

What are the current parking arrangements within the proposed area? Please tick the appropriate box*

Timed parking
Paid parking
Unrestricted Parking
Parallel parking

Work Zone signage required?*

YesNo

Work location address

Street Address:*

City:*

State:*

Post Code:*

Country:*

Maximum total combined file size is 10MB.

Sketch or plans of work zone area

Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx

Terms and conditions

A permit can be canceled by the Town
All vehicles parked within the work zone must display a copy of the permit or they may be subject to receiving a parking infringement
This permit will not stop an infringement being issued to a vehicle if parked in an illegal manner such as and not limited to:
Parked on or across a driveway,
Parked on a resident’s verge without permission,
Parked in an ACROD bay without the required permit, Parked contrary to yellow edge line markings,
Parked in a No Stopping/Parking Area,
Parked in a public place exceeding 24 hours, or
Parked against the flow of traffic
Any infringement incurred by the applicant or person will not be considered by the town for withdrawal and payment of the infringement penalty [includes any additional feed incurred] is required
The supplied site plan/sketch must clearly show the proposed length of the work zone[that is the number of parking bays or equivalent length required] and the location of the work zone

Acceptance of Terms and Conditions*

I declare that I have read and understood the above-mentioned Terms and Conditions and that all information in this application is true and correct. I accept and undertake to comply with the conditions specified on the permit and understand and accept that all fees are non-refundable.

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