Application for Heavy Vehicle Parking Permit

  1. Your details

Name
Street address
Postcode
Phone number / Mobile number
Email address
  1. Business details (the registered owner of the vehicle, if different to above)

Business name
ABN/ACN Number
Contact name
Business address
Postcode
Phone number / Mobile number
Email address
  1. Vehicle details

Vehicle make/model
Vehicle registration / Vehicle colour
Vehicle length / Vehicle GVM
Time vehicle arrives at property
Time vehicle departs property
  1. Additional details

Application fee $95.00 Code 517 / New permit / Permit renewal

This application is for one heavy vehicle with a gross vehicle mass over 4.5 tonnes. If you have two or more heavy vehicles please contact Council’s Planning Unit on 9747 7200.

Your application will not be processed unless the application fee payment is received together with the completed form. Incomplete applications will not be accepted. This fee is non-refundable if the permit is cancelled or rejected.

Council may or may not issue a permit with or without conditions and may also cancel a permit at anytime. A permit will be valid for 12 months upon being issued.This permit is non-transferable. If you are applying for a new permit or a renewal, you need to complete this form and submit it at least 28 days before the expiry date of the existing permit or the commencement of parking the heavy vehicle at the premises listed above.

All adjoining neighbours will be consulted by Council prior to a permit being issued.

Please note that a sketch plan indicating where the vehicle will be kept providing the distances of surrounding houses and fences must be provided with this form.

  1. Declaration

I (name) ______of (address) ______
in the state of Victoria do solemnly and sincerely declare that the heavy vehicle is owned/driven by me and that the information supplied regarding the stated vehicle registration is true and correct.
Signature / Date
______/ ______

Privacy Statement: The personal information requested on this form is being collected by Council for the purpose of meeting its legal obligations under the Road Safety Act1986, Environment Protection Act 1970, Summary Offences Act 1966, Local Government Act 1989, Impounding of Livestock Act 1994, Domestic Animals Act 1994, Infringements Act 2006 and associated or related legislation. The information will be kept confidential and identifying information will not be disclosed to any person for any other purpose. You may access your own information by contacting Council's Local Laws unit on 9747 7200.

Office use only
Permit number / Receipt number
Officer / Signature
Is the application / approved? / rejected?
Officer comments
Date:

Please return completed form to:

Mail:Email:Phone:

Melton City 747 7200
PO Box 21, (max. file size: 10MB)Fax:

Melton VIC 33379743 9970