Approval no. Date issued Date expires Excavation (Road Opening) Work Approval This application form is for approval to undertake work on public unleased land that includes interference with Territory property, under Section 19 of the Public Unleased Land Act 2013. The following conditions apply: 1. All works are to be undertaken using a temporary traffic management plan which shall be authorised by Roads ACT prior to works commencing. 2. The applicant shall backfill excavations and reinstate the surface of a public unleased land in accordance with TAMS Specification for Urban Infrastructure Works. 3. Paved surfaces (e.g. asphalt, sprayed seal, pavers and concrete) shall be temporarily reinstated with 50mm thickness of compacted coldmix or asphalt as a minimum until the surface is permanently reinstated. Backfilling and the temporary/permanent restoration of a surface are to be undertaken by competently trained persons. 4. The applicant shall be responsible for the maintenance of temporarily reinstated surfaces until the pavement is permanently reinstated in accordance with TAMS Specification for Urban Infrastructure Works. 5. A 12 month defects liability period applies to each restoration. The defects liability period starts on the date that the temporary traffic management plan expires. Application details Applicant’s name: Organisation’s name: Organisation address (including postcode): Phone number: Location of excavation Suburb and street: Block and section: Applicant’s signature: Application approved Approval officer’s signature: