Street Works Notice Ref: …………………
Form valid from June 2012
temporary traffic order APPLICATION FORM
Please Send Your Applications to:
Suffolk County CouncilNetwork Assurance Team
Phoenix House
3 Goddard Road
Phoenix House
Ipswich
IP1 5NP
Tel: 01473 341440 Fax: 01473 740984 / Fee (payable in advance): £770.00
YOU MUST ALLOW AT LEAST 3 MONTHS FOR THIS ORDER TO BE PROCESSED. A STREET WORKS NOTICE MUST HAVE BEEN SUBMITTED BEFORE THIS FORM WILL BE CONSIDERED
Form valid from June 2012
PLEASE TICK ALL RELEVANT OPTIONS THAT APPLY:
√ √ √ √
ROAD CLOSURE / FOOTPATH CLOSURE /SPEED LIMIT
/ OTHER (Please specify below)Description of Works:
Road Name
Parish / TownRoad Number (i.e.: A140)
Location of Works
Closure Start Date: / End Date:
If not 24hrs state times:
Diversion Route – List all roads (with names and numbers if possible)
It is not acceptable to write ‘see plan’
Does the above route have any restrictions, i.e. Low bridges, weight limits, tunnels, fords, ‘one way’ or other Orders on it? (If Yes then please give details). /
Yes / No
Details:
Passenger Transport
Contact Details:
01473 265021 or
01473 265017
Application will be rejected if this box has not been completed / This closure and diversion route have been discussed with:
On:
Applicants Details
Company Name: / Your name:
Address:
Tel.No: / 24hr Works Emergency
Contact No.
Email: / Your Order Number/Ref/Budget Code
Please note: It is the applicant’s responsibility to inform residents, businesses, the Local Parish Council and County Councillors about the closure. We may request to see the information you have sent them prior to sending you the legal order. If you need advice on who the Councillors or Clerks are please contact the area highways office.
FAILURE TO CONSULT WITH OR INFORM 3RD PARTIES MAY RESULT IN AN APPROVED ORDER BEING WITHDRAWN.
Form valid from June 2012
REQUIRED ADDITIONAL IMPORTANT INFORMATION
1. Access must be allowed to Emergency Services at ALL times.
2. Pedestrian/Cyclist and Access to properties must be allowed at ALL times, unless otherwise agreed.
3. An order will only be granted where a suitable alternative route or arrangements are available.
4. A clear plan showing the extent of the closure and diversion route must be attached to this application.
5. Signs 1050mm by 750mm bearing the words “This Road will be closed “From ………. To …………..” and including the dates of the closure MUST be placed at all approaches to the site at least 7 days prior to the proposed closure.
DECLARATION:
All the information given in this application is true and I have checked all the names of streets and parishes against an official map of the area.
Applicant’s Signature:………………………………. Date: ………….…………..
Company…………………………………………………………………………………
Position…………………………………………………………………………………..
Form valid from June 2012