Form SWT
Application to make a temporary
excavation in the Highway under
New Roads and Street Works Act
Application Ref:
SECTION 1 (Applicant Details)
Name: ……………………………………………………………………………………………………………………………
Address:…………………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………………………….
……………………………………………………………………………………………….. Postcode:……………………….
Tel. Work:……………………………………………..……………. Tel. Home:……………………………………………..
Fax:…………………….…………………………..
Contact Name:…………………………………………………………………………….……………………………………
SECTION 2 (Location of the Proposed Works)
Property Name/No:………………………………………………………………………………………
Road/Street:………………………………………………… Area:…………………………………….
Postcode:……………………………… National Grid Ref:…………………………………………….
The application must be accompanied by a 1:1250 scale plan showing the line of the apparatus within the
highway, including the point of connection to any other existing apparatus.
SECTION 3 (Details of the Works)
Description of Work:………………………………………………………………………………………
Estimated Length of Excavation (Metres):…………………………………………………………….
Depth of Excavation (Metres):…………………………………………………………………………..
Proposed Start Date:………………………………… Planned Finish Date:…………………………
Proposed Traffic control: (Stop/Go Boards) – (Temp. Traffic Signals) – (Road Closure) – (None Required)
Form SWT
Application Ref:
SECTION 4 (Details of Person/Company Undertaking Works)
Name:……………………………………………………………………………………………………………………………
Address:…………………………………………………………………………………………………………………………
…………………………………………………………………………………………..Postcode:……………………………
Tel. No:………………………………… Fax. No:………………………………………
SECTION 5 (Public Liability Insurance (minimum £5 million cover) Proof must be submitted with this form)
Company Name:…………………………………………………………………………………………………………………
Address:…………………………………………………………………………………………………………………………...
…………………………………………………………………………………………..Postcode:……………………………
Policy Number:……………………………….…..…………. Policy Expiry Date:…………….…….………………………
SECTION 6 (Declaration by Applicant)
I confirm that the foregoing details are correct and acknowledge that the works referred to above must
be conducted in accordance with the requirements of the New Roads and Street Works Act 1991 and
associated legislation and codes of practice.
I also acknowledge the statutory need for me to the prescribed inspection fees which will be imposed by
the Street Authority (Derby City Council) including any defect inspection fees and the cost of any
necessary remedial works conducted by the Street Authority during the guarantee period.
I also acknowledge that approval is granted on condition that I will indemnify the Street authority against
any claim in respect of injury, damage or loss arising of:
(a)
The execution by any person of any works authorised by the approval letter.
Signed:……………………………………………………….. Date:………………………………………
Please Print Your Full Name:……………………………………………………………………………..
Note – You must allow 6 weeks for the Application to be Processed.
Highway Authority Use Only
Fee
Insurance
Supervisor
Operative
Plan
Company Registered No.
Received
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Yes
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No
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SWT (Trial Excavation) Guidance Notes
It is an offence under Section 51 of the New Roads and Street Works Act 1991 (NRSWA) to
excavate in the Highway without first obtaining Approval from the Council
Section 1
This is the name and address of the Applicant.
Section 2
The application must be accompanied by a 1:1250 scale plan showing the line of the apparatus
within the highway.
Section 3
Provide details of type of work proposed including any proposed traffic management.
General Notes
A suitable qualified person, in the type of work being undertaken, must supervise the works. At all
times there must be on site a person holding the Operatives qualification, for the task being
undertaken. Please provide copy of Supervisors and Operatives Accreditation with this application.
The Applicant shall ensure that he or any contractor employed by him shall comply with all
relevant conditions of the NRSWA 1991including the relevant codes of Practice.
The Applicant must give details of proposed Traffic Management measures in section 2. You must
allow at least six weeks if you purpose to carry out the works under a road closure.
All Traffic Management proposals will need to be agreed with Network Managers who can be
contacted on 01332 641825
All reinstatement will be guaranteed for 2 years or 3 years if deeper that 1.5m
Please note that the Approval, notice and safety requirements outlined above are all legal
requirements.
The issue of an Approval Letter does not dispense the Applicant from obtaining any other consent,
licence or permission, which may be required, as detailed in NRSWA 1991 and associated
Regulations and Codes of Practice.
Fees
The fee for a Road Opening Permit to carryout a temporary excavation in the highway is £175.
This must be included with the application form and sent to:Derby City Council
Neighbourhoods
Network Management
The Council House
Corporation Street
DERBY
DE1 2FS