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 ROAD OPENING PERMIT
Minor Works conducted on any part of the road reservation in accordance with Road Management Act 2004 & Road Management (Works & Infrastructure) Regulations 2015, Schedule 1
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.
Property at which works will be carried out
(Fill in address of property) Works Proposed: (Please tick appropriate boxes)
Water Tapping Electricity connection
Sewer connection Stormwater connection Other __________________
(specify)
Opening in: (Please tick appropriate boxes)
Road Footpath Kerb & Channel
Nature strip Easement Laneway
Other __________________
(specify)
Description : (Please tick appropriate boxes)
Asphalt Road Concrete Footpath
Asphalt Footpath Other ________________________________
(specify)
Commencing Work Date (See Condition 4)
Payment Required
Application for Consent Fee
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$151.35
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Bond to be refunded to:
Name
Address( P.O. boxes not accepted)
Telephone - (BH) (Mobile)
Email Address
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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 $
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[This document does NOT constitute a Road Opening Permit]
For Office (Cashier) Use Only
Application Fee
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$ 151.35
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Receipt Type 495
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Final Inspection Fee
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$ 66.65
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Receipt Type 497
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Security Bond
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$
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Receipt Type 491 Trust Category: 15
Trust ID No: _______________________
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Applicant NAR:
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_____________________
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Inspection Fee (Service Auth Works)
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$
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Receipt Type 500
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(Please note: If works proposed are not of a minor nature then extra charges will apply in accordance Road Management (Works & Infrastructure) Regulations 2015, Schedule 1) Asset protection bonds may also apply.
IMPORTANT INFORMATION AND CONDITIONS
The permit holder agrees to indemnify and to keep indemnified and to hold harmless the Council, its servants and agents and each of them from and against all actions, costs, claims, charges, expenses and damages whatsoever which may be brought or made or claimed against the Council arising out of, or in relation to the granting of such permit.
The permit holder shall ensure that a public liability policy is effected, in a form approved by the Council, insuring for a sum of not less than $10 million, against all actions, costs, claims, charges, expenses and damages whatsoever which may be brought or made or claimed against the permit holder, or the contractor if applicable, arising out of, or in relation to the granting of such permit.
This permit is valid for 30 days only from date of issue and must be available on the job so as to be available whenever demanded. Failure to comply with any of the permit conditions or instructions from the Works Supervisor may lead to cancellation of the permit.
Work shall not be commenced until a permit is issued. Seven days notice is required prior to the commencement of works by contacting the Council’s Works Supervisor nominated at the time of taking the permit.
All fees are non refundable. All works are to be completed to Work Supervisor's satisfaction, if not a final inspection fee shall apply.
The Council may undertake rectification works after 14 days of permit expiry or if there is non-compliance with the permit conditions. The permit holder agrees to pay any charges which arise from this work. The costs may be deducted from any deposit or bond paid by the permit holder.
At final inspection all reinstatement works are to be completed to Council Officer’s satisfaction, if not a $90.00 final inspection fee shall apply.
The applicant may be required to lodge a refundable bond as determined by Council before undertaking any works within the road reserve.
It is the responsibility of the permit holder to ensure that locations of all services are known and the appropriate precautions required by the relevant authorities are obeyed. The Council will assist with information on its services. Information on other services can be supplied by Melbourne One Call System Tel. 1100
All vehicle crossings shall be constructed in accordance with Council Standard Drawings for Vehicle Crossings..
Unless otherwise approved by Council, the whole of the work shall be in accordance with Vicroads Standard Specification Section 706Q - Road Openings for Underground Utility Services.
Backfilling and reinstatement of all excavations is to be in accord with Council's Reinstatement of Disturbed Surfaces Guidelines, and temporarily reinstated with cold mix. Applicants should ensure they obtain a copy of this document from Council’s website: www.maribyrnong.vic.gov.au
Any excavations within the area covered by the drip line of trees or within 2 metres of the trunk require the prior approval of Council’s Aboriculturalist Tel. 9688 0200. The work should be in accord with Information for Contractors and Authorities concerning trees in the City of Maribyrnong available from the Council.
Unless specific approval is given to open trench, the road crossing shall be thrust bored beneath the existing pavement, shoulders or kerbs with a minimum cover of 900mm. Boring by water jetting is not allowed. The annulus between the bore and the pipe shall be backfilled by pressure grouting to prevent subsidence of the road pavement.
All new or replaced pipes or conduits for water, gas or other surfaces shall be laid with cover of at least 900mm below the surface level of the road pavement, at least 900mm below channel invert level and 450mm below the level of the footway as applicable.
All pipes to be used for drainage purposes shall be of ductile iron, cast iron or reinforced concrete manufacture unless specifically approved by the Council. Pipes must not cross footpaths and roadways other than at right angles without the express approval of Council.
All work and machinery used on the site shall comply with the relevant EPA regulations
The applicant is responsible for public safety by using appropriate barricades, warning signs and lights. The permit holder shall be responsible for erecting and maintaining sufficient warning signs, lights and barriers in accordance with Vicroads Roadworks Signing Code of Practice, or as directed by the Council. The Council reserves the right to erect barriers and signs and/or control traffic etc. at a cost to the permit holder.
Works affecting through traffic shall be carried out between 9.30am and 4.00pm weekdays or at times approved by Council. Council may require the applicant to submit a Traffic Management Plan to the Traffic Engineer, (enquiries 9688 0200) compliance with existing Clearway, No Standing and other road safety regulations is required.
A minimum of 6m of trafficable width shall be available to traffic at all times or as otherwise approved by Council’s Traffic Engineer. Approval for all traffic control measures shall be obtained from the Traffic Engineer prior to commencing any works on arterial roads.
Construction vehicles shall be parked where they do not obstruct traffic on the through carriageway.
Trenches that may be hazardous to either pedestrian or vehicular traffic shall be adequately backfilled or covered with timber or steel decking and barricaded to protect the public.
Surplus excavated materials are to be removed from the road surface, footpath, naturestrip and the area left in a clean and tidy condition.
Permit or inspection enquiries Tel. 9688 0200 8.30 am to 4.00pm Monday to Friday.
30 June 2017
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