Appendix F
Application for Permission to Excavate in the Public Highway 'Permit to Dig'
ALL FIELDS MUST BE COMPLETED
1. APPLICANTS DETAILS
(Organisation carrying out excavation)
Organisation Name
Organisation Address
Telephone no.
Fax no.
Name of NRSWA holder:
Emergency contact name & no. (24hr)
Your internal job reference no.
2.DETAILS OF PERSON(S) REQUESTING WORK
(Customer requesting the use of the item)
Name
Address
Telephone no:
Fax no:
Emergency contract name & no: (24 hr)
3. LOCATION DETAILS
Outside/Opposite:
Full address:
Position of item on the Highway (please indicate)
Carriageway
Footway
Verge
Length of excavation (m):
Depth of excavation (m):
Width of excavation (m):
4. NATURE OF REQUIREMENT
Reason why excavation is required:
Licence no. associated to the works if applicable:
Proposed dates of use:
If no, proposed hrs:
From
To
Will excavations remain open during the night?
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5. TRAFFIC MANAGEMENT REQUIREMENTS
Type of traffic management required:
(please note that a separate application must be
completed for temporary controls (signals, stop
and go, and Traffic Orders)
The applicant MUST be a registered organisation - contact the Network Management Unit for a
registration form if not completed previously
This application MUST be signed by an authorised representative of the organisation applying. The
signature of this representative is taken as confirmation that all standard conditions have been read,
understood and will be adhered to. By signing, this representative confirms that the Network
Management Unit Licensing and Permissions Policy and Guidance Document and all associated
legislation and guidance is understood.
Signature of Applicant:
Printed Name of Applicant:
Date:
Completed forms should be sent to the Network Management Unit E-mail: nmu@staffordshire.gov.uk
Or Fax: 01785 854037
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Appendix F
Guidance Notes and Examples
This is the Staffordshire Highways standard pro-forma for applying to excavate in the
highway. This application form should not be used where apparatus is to be installed unless
a licence number is included (licence number for either vehicle access crossing or licence to
place apparatus). Any queries, please contact the Network Management Unit on 01785
276784
Box 1.
Name of the organisation carrying out the works.
NOTE: This address will also be used for invoicing unless notified differently.
Number of direct contact - this number should be a direct line or mobile and will not be
shared publicly but for internal purposes only.
Fax number: permit will be sent to this number.
A copy of NRSWA accreditation will be held against registered details for the applicant's
organisation. However, each application will require confirmation that this person will be
responsible for the site in question (in case they have terminated employment).
Emergency contact for highways staff should an issue arise on site both in hours and out of
hours.
Your internal reference number / job number (which will appear on invoices if on account)
Box 2.
Name of the Customer who has requested the works..
Address of the customer. This can be different to the location of the works in some cases but
if not, please enter 'as location'.
Customer contact number. This is required should additional contacts assist in resolving any
issues arising from the works.
Emergency contact for highways staff should an issue arise on site both in hours and out of
hours.
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Appendix F
Box 3.
Please note: an application is required for each street. Multiple excavations can be added to
a single application provided they are within 200m
Descriptive location(s) of excavation for e.g. O/s 54.
Full address of the works.
Please confirm whether excavations will be on the carriageway, footway or verge (tick
relevant)
Length in metres of the excavation. Excavations that do not fall within 200m will attract an
additional fee (see current rates for details)
Depth of excavation. Deeper excavations carry a longer guarantee period. See conditions for
details.
Width of excavation.
Box 4.
Brief detail of why the excavation is required for e.g. trial holes.
If the excavation is related to, for example, the installation of apparatus or a vehicle access
crossing, the licence number must be stated.
Proposed dates of work. Please note that permitted dates may be different to those you
propose.
Proposed hours of work. Please note that permitted dates may be different to those you
propose.
See conditions. Excavations should be closed by nightfall unless special permission
required.
Box 5
Detail traffic management type.
Signals, stop and go and closures (or other Traffic Orders) must be applied for separately
and forms are available on request.
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Appendix F
STANDARD CONDITIONS FOR TEMPORARY EXCAVATIONS IN THE HIGHWAY
SECTIONS 171 OF THE HIGHWAYS ACT 1980
GENERAL
1. No excavations shall be carried out in the highway without the prior approval of the
Highway Network Manager or their representative. To commence works on the
highway without written permission is an offence under The Highways Act 1980 and
may result in prosecution. The Permit holder must be able to provide a copy of the
permission if requested on site by a Highway Officer or Police Constable.
2. The Applicant must have the minimum public liability insurance cover of £5,000,000
for any one claim with no limit to the number of claims, proof of which shall be
required. The insurance must cover the full period that the permission covers works
on the highway including the reinstatement guarantee period. The Highway Authority
must be notified immediately of any changes to or termination of a policy that may
affect this insurance requirement.
3. The Applicant shall indemnify the County Council against any liability, loss, claim or
proceeding arising under the statute or common law in respect of the excavation,
reinstatement, signing, lighting, guarding, traffic management or other activity
associated to the works on the highway.
4. The applicant must be accredited in accordance with HAUC and all works and
reinstatements must be undertaken by the NRSWA qualified person(s) as specified
on the application form. Proof of this accreditation must be available for inspection if
requested by a Highway Officer or Police Constable. The permanent reinstatement
must comply with the HAUC Specification for the Reinstatement of Openings in the
Highway, Second Edition 2002, together with amendments (or any successor
document current at the time of the works).
5. The site must be safe at all times and comply with current legislation with regard to
signing, lighting and guarding as failure to do so could result in prosecution.
6. All works will be guaranteed as required by HAUC and the applicant is responsible for
rectifying any defects within specified timescales once notified by the Highway
Authority. Failure to do so will result in costs being recharged to the applicant.
7. The Applicant must allow at least fifteen clear working days between the submission
of the application and the proposed start date. This is to ensure that the correct
notices are submitted as required by the New Roads and Street Works Act 1991 and
the Traffic Management Act 2004 Further time may be required subject to processing
traffic management requests (see condition 8 below with regards to traffic
management approvals).
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Appendix F
8. Where permission is granted, this relates only to the works and not to the use of traffic
management (signals, other controls, Traffic Regulation Orders) which if required,
must be applied for separately. Contact the Network Management Unit for advice.
9. The applicant is responsible for any remedial costs for consequential damage to the
highway resulting from the works or reinstatement.
10. The Applicant shall ensure that all temporary excavations are reinstated as quickly as
possible. The Highway Authority is entitled to apply a charge to works unreasonably
occupying the highway and the permit holder may face a fine where works have
remained open for an unreasonable duration.
11. Where multiple excavations are required, these should be carried out consecutively
where each excavation is reinstated prior to the next excavation commencing. The
applicant must state on application if this is not possible as special conditions will be
applied.
12. In situations where works are in the vicinity of a railway level crossing:
1) The application must clearly state this is the case
2) The rail authority must be informed (presently Network Rail, contact details
available on request)
3) The applicant must comply with relevant legislation (available on request)
13. Plant belonging to statutory undertakers may exist in the vicinity and any damage
caused to this plant by your works or any activity associated to the works will be the
responsibility of the applicant. The applicant must contact all statutory undertakers
prior to commencing works to notify them of the works and to establish the location of
existing apparatus that may be affected by the works. Safe digging practices must be
adhered to, to ensure the safety of the operatives, the public, assets owned by
statutory undertakers and the highway structure (contact the Network Management
Unit for contact information).
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