PERMIT APPLICATION PARK A HEAVY VEHICLE IN A RESIDENTIAL ZONE LOCAL LAW NO. 1 – STREETS & ROADS – Clause 31 To park a heavy vehicle or trailer over 3 tonnes (Gross Vehicle Mass) on a road reservation or land owned by Council or privately owned lands with an area zoned residential. Applicant Name Organisation Address Telephone Email Address Preferred method to receive permit: □ Fax □ Mobile Fax Email Post □ □ Collect from ISC office Dates for which the permit is sought: Location / Address for which the permit is sought: Private or Public Lands: Times of arrival: Times of departure: Vehicle registration number: Make of vehicle: Model of vehicle: Tare weight: Important Requirements: The applicant MUST hold current Public Liability Insurance for an amount not less than TEN MILLION DOLLARS ($10,000,000) and must produce to Council evidence of such insurance. (Certificate of Currency) The applicant must comply with any and all terms and conditions attached to the permit A copy of the current vehicle and trailer registration certificate by a certified authority is required A non-refundable application fee of $202.50 per annum is payable on lodgement The permit will only be valid for the dates applied for Checklist for required items (The application will be returned to the applicant if documentation is not attached) Copy of current Public Liability Insurance-no less than TEN MILLION DOLLARS Copy of current vehicle and trailer registration Application Fee $202.50 per annum Permit Number: ____ ______________ Receipt Number: ____________________________ Customer Service Officer: _____________________ Signature of Applicant: _____________________________________ Date: ____________________ 687323008 1 PERMIT APPLICATION PARK A HEAVY VEHICLE IN A RESIDENTIAL ZONE Privacy Policy Information Personal information collected by Council is used for municipal purposes as specified in the Local Government Act 1989. The personal information will be used solely by Council for these purposes and/or directly related purposes. Council may disclose this information to other organisations if required by legislation. The applicant understands that the personal information provided is for the above purpose and that he/she may apply to Council for access to and/or amendments of the information. Any requests for access and/or correction should be made to Council’s Privacy Officer. Terms and Conditions 1. In these Conditions, “Heavy vehicle” means a vehicle with a gross vehicle mass of greater than 3 tonnes including trailers associated with heavy vehicles. “Council” means the Indigo Shire Council. “Permit Holder” means the person or trading body nominated by the applicant. “Premises” means the premises described on the Permit Application. 2. The permit holder must ensure that the “Heavy Vehicle” is located as stipulated in this Permit and in any event in a position that: Is not within 9m of an intersection or 18m or a bus stop or a pedestrian/school crossing; Does not obstruct a vehicular crossing Does not contravene any traffic control signs 3. The permit holder must ensure that the placement will not: obstruct the passage of vehicles and pedestrians; obscure the view of motorists; or present a physical hazard. Damage Council assets Make noise deemed offensive as per the EPA Act Contravene any part of the conditions associated with the consideration of this application or issuing of this permit under section 32 of Local Law number 1. 4. The permit holder must take reasonable care to prevent any person being: injured; and unduly inconvenienced by the vehicle whilst placed on the road reserve or on private lands. 5. The permit holder shall at all times during the agreed term, be the holder of a current Public Liability Insurance Policy in respect of the activities specified herein in the name of the permit holder providing coverage for a minimum sum of $10 million. The Public Liability Policy shall be affected with an insurer approved by the Council. 687323008 2