Application for a Permit for Works-Placement in Road Reserve Form

Terms and Conditions apply. Please read prior to completing this form.

A NON REFUNDABLE APPLICATION FEE is required to process this application, the fees are:

• No Fee (Skip Bin - Verge) (for less than 14 days)
• $45.00 (Skip Bin - Verge) ( for longer than 14 days)
• $55.00 (Skip Bin – Road)
• $135.00 (All Others excluding Right of Ways)
• $200 (Works or Obstructions - Right of Ways) (this also requires a $500 refundable bond)

* All applications require a minimum of three business days for assessment.

Company

Contact name*

* Required Field.

Address*

* Required Field.

Phone number*

* Required Field.

Email*

* Required Field.*

Site address*

* Required Field.

Cross streets

Size & type of equipment*

* Required Field.

How many lanes?

Date of work commencement*

* Required Field.

Requested work completion date*

* Required Field.

Times*

* Required Field.

If works are to be conducted outside of the normal working hours of 7am to 7pm, Monday to Saturday, then an 'Out of Hours' noise permit must be obtained through our Health department - contact mail@vincent.wa.gov.au

Area to be obstructed*

• Road Obstruction
• Footpath Obstruction
• Verge Obstruction
• Right of Way

Type of obstruction*

• Skip Bin(s)
• Container
• Cherry Picker
• Crane
• Other

If other (Please Specify)

Any application involving road closures, right of way obstructions and/or footpath obstructions must be accompanied by a traffic management plan and/or site plan.

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Additional Plans (If required)

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Will there be an accredited traffic controller present during the duration of the works? This is required for all road and right of way obstructions and footpath closures*

YesNo

* Required Field.

I confirm all information is true and correct, to the best of my knowledge, and understand that APPROVAL must be given prior to obstruction.*

I Agree

I have read and understood the conditions that may be imposed on the permit.*

I Agree

Payment By Credit Card

Skip Bin on Verge for longer than 14 days is $45.00, Skip Bin on Road is $55.00, all other applications are $135.00 (excluding right of ways), Right of Way obstruction is $200 which also requires a $500 refundable bond.

Once the application has been submitted, a credit card authority form will be emailed to you for completion of payment for the application fee.

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ISSUING OF A PERMIT WILL BE SUBJECT TO CONDITIONS, EXAMPLES INCLUDE

• 72 hours notice between Monday and Friday must be given prior to the operation due date.
• Built strata properties will require written approval from the managing agent(s) before a permit will be issued for use of the verge. In a survey strata scheme only lots adjacent to the verge will be granted a permit to use the verge.
• The area of operation must be adequately signed and barricaded from vehicles and pedestrians. Full temporary signage is to be in place when lane is obstructed, in accordance with AS 1742.3  2002.
• The City is to be indemnified against any claim or action arising from the operation.
• Barricades must be used to provide safe movement of pedestrians together with safe access for pedestrians being provided at all times.
• The movement of all path users, with or without disabilities, within the road reserve shall not be impeded during building works. 
• The area shall be maintained in a safe and trafficable condition and a continuous path of travel (minimum width of 1.5 metres) shall be maintained for all users at all times during construction works. Note: If the safety of the path is compromised by either construction damage or a temporary obstruction then appropriate warning signs (in accordance with AS1742.3) are to be erected. If a continuous path cannot be maintained, temporary pedestrian facilities suitable for all users shall be installed. Prior approval must be obtained from the Director Technical Services if scaffolding, site fencing or the like is to be erected, or building materials stored, within the road reserve.
• Access to commercial properties and businesses is to be maintained at ALL times.
• ALL affected householders/businesses are to be notified in writing by the applicant at least 24 hours prior to commencement of works.
• The requirements of the Police Traffic Branch must be complied with.
• The requirements of Work Safe Western Australia must be complied with at all times.
• Full protection to footpath/road under outriggers must be provided.
• The bin must not exceed two (2) metres in width.
• Bin must be placed adjacent to kerbline on verge with footpath to remain clear of obstruction and available for pedestrian use at all times.
• The bin must have an approved reflective device or flashing amber lights placed at either end and be lit from dusk to dawn every night.
• No material is to be placed adjacent to the bin, all rubbish must be contained within the bin, and the bin is to be immediately emptied once full.
• Any damage to road or footpath must be repaired at the applicant’s expense in accordance with City’s specifications within 24 hours.
• City reserves the right to amend the conditions of the permit and/or request immediate removal of the obstruction without prior notice at anytime.
• Bin is to be placed on the road directly adjacent to the kerbline at the approved location, but not in contact with the kerb.
• Existing kerbside “Clearway” & "No Stopping" restrictions to be adhered to at ALL TIMES.
• Hours of work to comply with Environment Protection (Noise) Regulations 1997.
• The Applicant is to employ a Main Roads Western Australia accredited traffic management organisation to supply and implement traffic management, and a copy of the organisation's traffic management plan is to be supplied to the City of Vincent’s Technical Services Division prior to the commencement of works.
• Vehicles may not make use of the set aside bays at any time.
• Building materials to be fenced off with bunting and reflective tape and remain clear from pedestrian traffic. Star pickets require capping to be in place and secured.
• Storage of loose construction material is not permitted in the set aside bays.
• Storage of equipment and materials on the verge must be kept a minimum of one (1) metre from the base of street verge trees and any other infrastructure that is located on the verge.
• No building activity is to be carried out on the thoroughfare or verge area.
• Applicant is to re-apply before expiry date of permit, if works are to continue beyond permit expiry date.
• Failure to comply with the Permit conditions is an offence. The City reserves the right to cancel the permit if the above conditions are not adhered to.