Maribyrnong city council



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MARIBYRNONG CITY COUNCIL Date ....................................


Application No:
Municipal Offices

Corner - Hyde & Napier Sts

(61 Napier Street)

P O Box 58

Footscray 3011

Tel. 9688 0200



APPLICATION FOR VEHICLE CROSSING PERMIT

Please complete this form and return together with payment to Maribyrnong City Council, PO Box 58, Footscray 3011 or at the Municipal Offices, corner Hyde and Napier Street, Footscray between 8:30 am to 5.00 pm.


Site Address

(Fill in address of property)


Bond to be refunded to:

Name

Address( P.O. Boxes not accepted)

Telephone - (BH) (Mobile)

Email Address


Carrying Out Works: (the person or body that is responsible for conducting these works)

Company Name ABN:

Name of Works Manager

Address( P.O. boxes not accepted)

Telephone - (BH) (Mobile)

Email Address

Name of Public Liability Insurance Company

Amount of Public Liability Cover $



Works Proposed: (Please tick appropriate boxes)



Is the proposed crossing

  • A single residential crossing up to 3.3 metres wide

  • A single commercial crossing up to 6.0 metres wide

  • A single residential crossing greater than 3.3. metres wide Width ……………m

  • A single commercial crossing greater than 6.0 metres wide Width ……………m

  • A multiple crossing to my property Number …………

  • Relocate an existing crossover.


Is there an existing crossing which is proposed to remain Yes No
Is there a Planning permit issued for this proposed crossing Yes No
If yes please provide the Planning Permit number TP ……………………
Is the property in a Heritage or Flooding Overlay Yes No
Residential - Is the property frontage over 11 metres Yes No
For a corner property, please specify frontage (m) ……….. side (m) …………..
Commercial - Is the property area less than 2,500 sqm Yes No
If no. specify size …………..sqm

________________________________________________________________________________________________


Is there a parking space 5.5 m long available within the property Yes No
Is the proposed crossing within 18 metres of an intersection with traffic signals or within 9 metres of an un-signalised intersection. Yes No

Assets that may be affected by the proposed crossing/s

(Please tick appropriate boxes)

Please indicate anything that may be affected by the construction of the crossover.


Tree

A tree may be considered to be affected if excavation will be beneath the tree canopy. Council’s Technical Officer – Arboriculture must assess the tree prior to the issuing of a permit and you may be required to pay a fee for the removal and/or replacement of the tree.


Drainage Painted or constructed parking bays
Street Signs Other Specify ………………………………………………………………………

________________________________________________________________________________________________


Site plan
Please provide a sketch below of the site showing the proposed crossing including dimensions and adjoining streets or attach a separate site plan.



I declare that the information supplied on this application is true and correct



Applicant’s signature ............................................................ Date …………………………….
NOTES:

  1. Applications and fees (including Bond) are assessed within five (5) working days in most cases.

  2. Non standard crossings where trees are to be removed or other asset issues to be resolved may delay the granting of a permit within five (5) working days.

  3. The applicant will be notified by Council whether a permit is granted.

  4. Fees are payable upon collection of the Vehicle Crossing Permit from Customer Services at Municipal Offices, Corner Hyde & Napier Streets, Footscray unless notified otherwise.

  5. Additional fees may apply in accordance with Council’s Vehicle Crossing Policy.

  6. Any inaccurate information supplied may render the permit null and void.

  7. Further information may be obtained by contacting Council’s Operations & Maintenance Department on 9688 0200

(Please note: Permit Fee is non refundable once Permit is issued.)



Application Fee

Receipt Type

Vehicle Crossing up to 3.3m wide

$304.10

496

Vehicle Crossing greater than 3.3.m wide

$412.00

498

Second/multiple vehicle crossing to property (each)

$562.00

499

[This document does NOT constitute a Vehicle Crossing Permit]

For Office (Cashier) Use Only

Vehicle Crossing Bond

Security Bond

$


Receipt Type 491 Trust Category: 16

Trust ID No: ­­­­­­_______________________



Applicant NAR:

_____________________


Please return this application form to Operations & Maintenance


30 June 2017




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