Amendment/extension of a Road and footpath occupancy permit application 1Introduction2Permit conditions3Applicant details4Amendment type5Occupancy timeframe6Amended documents You can use this form to: Apply for an amendment or an extension to an existing permit to occupy roads and/or footpaths managed by Council. Before you begin: It takes about 5 minutes to complete this form and you will need to: Tell us your name, address, email address, and phone number. Tell us your existing permit number and the site address where your permit applies. Tell us the type of amendment/extension you require, and the amended or extended days or details that you are requesting we change on your permit. After you complete this form we will: Send you an email confirming we have received your request. Assess your application. During this assessment we may contact you if additional information is required. If your request is successful, we will email you a tax invoice that you will need to pay before you are issued an amended/extended permit.. What happens with your information? We record your information on our customer database and make it available to relevant Council staff in line with City of Boroondara’s Privacy Statement. The contact details you provide to Council may be used by Council to contact you in relation to other Council functions and services. Permit conditions * Required I declare that I am an authorised person to request an amendment / extension and that all information within this request is true and correct. I will not undertake any works without a valid permit in place. For an amendment to my permit, I understand changes can only be made up to 10am on the valid permit date and after 10am I will be charged for the full day. For an extension, I understand this request can only be made whilst the permit is valid. Any requests for an extension after the expiry date of a permit will require a new application. Any applicable application fees will be non-refundable. I agree to the permit conditions above I have read and accept Council's Privacy Policy and understand how my information will be used. * Required Yes Contact name * Required First name Surname Email address * Required Phone number * RequiredCompany name Site address * RequiredIf you cannot find your address in the lookup tool, you can enter a custom address.Permit number * RequiredYour permit number is located in the top right-hand corner of your issued permit. Amendment type * Required Add, change or remove days Change to size of the current permit area Change to the traffic/pedestrian management plan Please provide the original dates that are authorised on your permit.Original date from * Required DD slash MM slash YYYY Original date to * Required DD slash MM slash YYYY Please provide the amended/additional dates you are requesting to be changed for your permit.Amended date from * Required DD slash MM slash YYYY Amended date to * Required DD slash MM slash YYYY Proposed times you will be occupying the area * Requirede.g. 7am to 6pm weekdays, 9am to 5pm Saturdays (you may add up to 6 additional rows using the plus icon). Outside of these hours you will need an out of hours permit.Start timeEnd TimeDay Please upload your amended documentation below. A size limit of 4MB applies to each upload. Allowed file types include: jpg, jpeg, png, doc, docx, pdf.Please provide your amended site plan of work Drop files here or Select files Accepted file types: jpg, jpeg, png, doc, docx, pdf, Max. file size: 4 MB, Max. files: 1. Maximum file size – 4 mega bytes. Please provide your amended Traffic/Pedestrian management planIncluding aftercare plan if applicable Drop files here or Select files Accepted file types: jpg, jpeg, png, doc, docx, pdf, Max. file size: 4 MB, Max. files: 1. Maximum file size – 4 mega bytes. Please provide your amended Memorandum of Authorisation (MOA) Drop files here or Select files Accepted file types: jpg, jpeg, png, doc, docx, pdf, Max. file size: 4 MB, Max. files: 2. Maximum file size – 4 mega bytes. Certificate of Currency with public liabilityPublic liability minimum 20 million Drop files here or Select files Accepted file types: jpg, jpeg, png, doc, docx, pdf, Max. file size: 4 MB, Max. files: 1. Maximum file size – 4 mega bytes. Please provide a copy of your intended updated notification letter Drop files here or Select files Accepted file types: jpg, jpeg, png, doc, docx, pdf, Max. file size: 4 MB, Max. files: 1. Maximum file size – 4 mega bytes. Other approvalsCitiPower, Yarra Trams, National Heavy Vehicle Regulator, Other Public Transport approvals etc. Drop files here or Select files Accepted file types: jpg, jpeg, png, doc, docx, pdf, Max. file size: 4 MB, Max. files: 1. Maximum file size – 4 mega bytes. CommentsThis field is for validation purposes and should be left unchanged.
