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SKIP PERMIT

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					SKIP PERMIT
EALING COUNCIL
Customer Services
First Floor Perceval House
14-16 Uxbridge Road
Ealing
W5 2HL                  DIRECT LINE: 020 8825 6000
                               FAX: 020 8825 5553
IMPORTANT NOTICE
PERMITS WILL NOT BE ISSUED TO ANY PERSON IF THE SKIP COMPANY THEY PROPOSE TO USE HAS
NOT BEEN REGISTERED WITH EALING COUNCIL

(1) DETAILS OF APPLICANT (SEE NOTE; 1 & 2)

SURNAME _____________________________________________ FORENAME ____________________________________________

ADDRESS _____________________________________________________________________________________________________

POST CODE ___________________________________________ TEL NO ________________________________________________

(2) SITE PARTICULARS

SITE ADDRESS ________________________________________________________________________________________________
PLEASE STATE IF SITE IS IN A CONTROLLED PARKING ZONE AREA (CPZ)           YES/NO
NUMBER OF SKIP(S) (IF MORE THAN 1 SKIP IS REQUIRED ON A SITE - SEE NOTE 6) _________________
PERIOD OF SKIP(S) (MAXIMUM IS 1 CALENDAR MONTH – SEE NOTE 10) _______________________________________________
DATE FROM ____________________________________ DATE TO ______________________________________________________

(3) DETAILS OF SKIP COMPANY: PERMITS WILL NOT BE ISSUED WITHOUT THE FOLLOWING DETAILS

SKIP COMPANY NAME __________________________________________________________________________________________
ADDRESS _____________________________________________________________________________________________________
________________________________________________         TEL NO ________________________________________________
SIGNATURE OF APPLICANT (SEE ALL NOTES ON REVERSE) __________________________________________________________
I THE SIGNATORY BELOW, AGREE TO COMPLY WITH THE PROVISIONS OF SECTION 139 & 140 OF THE HIGHWAY ACT 1980. I
ACCEPT THE RESPONSIBILITY FOR THE SKIP WHEN ON THE HIGHWAY, AND IN PARTICULAR FOR THE LIGHTING OF THE SKIP
DURING THE HOURS OF DARKNESS. I ALSO ACCEPT CONDITIONS IMPOSED BY SKIP COMPANIES REGARDING THE ABOVE
RESPONSIBILITIES. I FURTHER ACCEPT RESPONSIBILITY FOR ANY COST INCURRED BY EALING COUNCIL DUE TO MY
FAILURE TO COMPLY WITH ANY OF THESE CONDITIONS.

SIGNATURE OF APPLICANT ______________________ FULL NAME IN BLOCK CAPITALS __________________________________


STATUS OF SIGNATORY EG. BUILDER, HOUSE OWNER ETC (SEE NOTE 2 ON REVERSE) ___________________
Payment Type (Please Tick): Cash   Credit/Debit Card   Cheque    Postal Order
                                      Details of Payment Methods Overleaf


FOR OFFICE USE ONLY

RECIEPT NUMBER _______________________ PAYMENT ___________________ DATE RECEIVED _________________________
PERIOD AGREED FROM ______________________ TO _______________________________________________________________
AUTHORISED SITE _____________________________________________________________________________________________
OFFICER _________________________ DATE _________________ AREA ___________________ PERMIT NO __________________
Notes for applicant
    1    If an applicant is an individual, please insert the Applicant’s full name and address. If the applicant is a
         company, please insert the Company’ full name and address.

    2    The applicant and signatory must be the same person. When the applicant is a Company, the position in the
         Company of the signatory is to be also inserted.

    3    Applications for skip permits must be made on this form

    4    No skips can be allocated on a pay & display.

    5    The fee for a skip permit is £20 per skip. If you live in a CPZ you will be required to pay an additional £10.00
         per skip. No refunds will be given.

    6    If more then 1 skip is required on a site, the application must be checked and agreed by an enforcement
         officer before the permits are granted.

    7    To renew your skip permit application you will be required to complete another form and pay the relevant
         fees.

    8    The person signing the application form (Skip Permit Holder) is responsible for the following:
         Ensuring the skip is sited as directed on the permit.
         Ensuring the contents of the skip are not allowed to fall onto the highway.
         Ensuring the skip is lit during the hours of darkness.
         Ensuring the skip is removed when the permit expires.
         Ensuring the highway in the vicinity of the skip is kept clean and tidy at all times.

    9    Lights on skips that are stolen are to be reported to the police.

    10   Inspections are carried out periodically both during the daytime and after lighting up time. Persons found not
         to comply with the conditions of the permit will be subject to costs incurred and reported to Ealing Council’s
         Legal Services for action to be taken.

    11   The permit will be valid for one calendar month from the date specified on the permit and a new application is
         required if a skip is to remain on the public highway after this time. New renewal applications should be made
         at least 3 working days prior to the existing permit expiry.

    12   Applications take approximately 48 hours to be processed, enquiries for permit numbers Monday to Friday on
         020 8825 6000


Payment details
         BY POST: This form together with a cheque, postal order or contact telephone number for credit or debit card
         payment, should be posted to: Ealing Council, Customer Services, Multi-Media Team, First Floor, Perceval
         House, 14-16 Uxbridge Road, Ealing, W5 2HL.

         BY FAX: 020 8825 5553

         IN PERSON: Cash payments, cheques, credit or debit cards and postal orders can be taken to: Ealing
         Council Reception, Perceval House, 14-16 Uxbridge Road, Ealing W5 2HL

         Cheques and Postal orders should be made payable to Ealing Council.

         Please note: NO Credit or Debit Card details should be entered on this form.

				
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