CIVIL WORKS IN THE PUBLIC DOMAIN APPLICATION FORM

S.138, ROADS ACT 1993

The Fees and Charges for this application are as per the 'Civil Works in the Public Domain' section of Council's Fees and Charges.

About this application:

The lodgement of this application is not an automatic approval.
This application is for the approval of works in the road reserve other than: private driveways, footpaths,stormwater construction and road openings. A separate Driveway and Ancillary Work Application must be lodged for driveway and footpath constructions. A separate Road Opening Permit Application must belodged for road openings.
Works covered by this application:
-The erection of structures such as shelters, post, fence, signs, outdoor dining facilities and thelikeo
- Stormwater drainage works covered in part B of the stormwater specification, except private stormwater outlet connections (pipe sizes less than 150mm diameter)o Retaining walls;
- Road construction, re-grading or re-shaping of the road reserve;
-Other activities as defined in the Roads Act 1993 that are not covered by other applications.
Council will issue a letter with conditional approval following satisfactory submission of the documentationsas listed in this Application and payment of fees and charges within 15 working days from the date of this Application. The Application may be refused if information requested is not provided within the 15 working day period.
No work shall commence until written approval is given by Council.

For further information or questions regarding this form, please contact Council via 9911 6555.

Details of site

Site Address: *

Site No: *

Site Suburb: *

Site Postcode: *

Estimated construction period start date *

Estimated construction period end date *

Development Application Details

Is there a current Development Application (DA) or Complying Development Certificate (CDC) associated with the property? *

YesNo

DA/CDC number: *

Date DA /CDC lodged: *

Application details

Tick the appropriate boxes *

Erection of structures such as posts, fences, etc.Stormwater drainage works except storm water outlet connectionRetaining wallsKerb and Gutter constructionCivil works such as road pavement construction, re-grading or re-shaping of the road reserveOther activities as defined in the Roads Act 1993

Description and Estimated Cost of Works *

Estimated Cost of Works: *

Contractor details

Contractor Name: *

Contractor company Name: *

Company mailing address: *

Company mailing suburb: *

Company mailing postcode: *

Phone (w): *

Phone (m): *

Email Address *

Documentation required

This information is to be submitted to Council along with the lodgement of this application form. Once all information listed is re ceived, Council will review your application and post a letter of conditional approval. Please refer to SECTION 2 of Council’s Section 138 Fact Sheet for descriptions o f the below:

Construction Drawings *

Browse

To be approved by Council prior to construction

Public Liability Insurance *

Browse

($20,000,000 minimum)

Construction Management Plan *

Browse

Site Specific Safety Management Plan

Browse

If applicable

Pedestrian Management Plan and/or Traffic Management Plan

Browse

If works are undertaken on the road

Dilapidation Report *

Browse

Copy of the most recent Dial Before You Dig cover sheet *

Browse

Letter of approval from RMS

Browse

RMS approval is required for all arterial roads

Conditions to be Satisfied During Construction

Please refer to SECTION 3 of Council’s Section 138 Fact Sheet for Terms and Conditions of Construction .

Conditions to be Satisfied After Completion - Checklist

The following information is to be provided at the com pletion of the work; Please refer to SECTION 4 of Council’s Section 138 Fact Sheet for desc riptions of the below:

Works-As-Executed Drawings
Engineers Certificate
Letter to Council requesting return of Security Deposit

Applicant Details and Declaration

Surname *

First Name *

Email address: *

Contact number: *

Company name:

Mailing address *

Mailing Suburb *

Postcode *

I declare that I have supplied all documentation required as per the Council terms and conditions, specified in the Section 138 Fact Sheet, in order to prevent delays in the processing of this application.

Applicant Signature *

Draw signature|Type signatureClear

Date signed *

DAMAGE DEPOSIT/ BOND APPLICATION FORM

Use this form when making payment for a damage deposit or bond

Property Details

Property Address:

Lot:

DP:

SP:

Applicant details (to whom the future refund will be released)

Surname:

First name:

Email:

Contact phone number:

Postal Address:

Refund method

I wish to nominate the following method of refund:

ChequeEFTCredit Card* (Not available for all refunds)

* Refund to the same credit card is the default method available only for damage deposit/bonds paid via Council’s eServices online portal. The card must be valid and current at the time of refund.

EFT account details

EFT account name

BSB number

Account number

1. I hereby state that the above information is true and correct;

2. I am the person responsible for making this damage deposit/bond payment and am the authorised person to receive the refund;

3. I will advise the City of Canada Bay Council of any changes to my address; bank account; or credit card, and understand that failure to update these details may delay payment of the refund at a later date.

Declaration

Signature

Draw signature|Type signatureClear

Date

Rams - RDApproval - Road Works

(For Internal Use Only)

RdWkrsApp, S138ApInsp