Work Zone Application Form

Please complete this application form if you wish to obstruct a verge/footpath/road within the Town of Claremont.

Please note the following Terms and Conditions:

The application is required to be submitted 7 working days prior to the commencement of works
If the application is not received within 7 working days prior to the start of works, additional fees will apply and the application may be declined
A scaled sketch /photo/ plan of the work zone must be provided with this application; failure to do so may result in the application being declined
For obstructing parking bays, refer to the 'Application to hire a parking bay form' found here
For Traffic Management approvals, please ensure accredited plans are included
Fees apply*; please refer to the following table:

FEES
Description	Fee
Work zone application fee (application received 7 days prior to works start date)	$56 (per 3 months)
Traffic Management permit fee	$244
Work zone application fee (application received less than 7 days prior to works start date)	$107 (per 3 months)
Traffic Management permit fee (application received less than 7 working days prior to works start date	$528

First Name *

Last name *

Company Name

Company ABN

Address of Applicant *

Mobile number *

Email address *

Request to obstruct *

Verge

Footpath

Road

Obstruction type *

If multiple verge(s), footpath(s), road(s) required, indicate here

Start day *

Finish Date *

Start time *

Finish time *

Nature of works *

Address where works are taking place *

Please provide a sketch of the work zone area *

Honeypot

Declaration - I have read and agree to the T&Cs *

Traffic Management Plans

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