Dear Please find attached roadfootpath closure and opening

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					                                                                          PO Box 1943
                                                                          Hervey Bay Qld 4655

                                                                          T 1300 79 49 29
                                                                          F (07) 4197 4455


Please find attached road/footpath closure and opening application. The following
application form is to be use for any festival, activity or construction work carried out
within a road reserve.

Please keep in mind as the principle contractor or persons responsible that you are
responsible to familiarise yourself and comply with the relevant manuals and policies.

With compliments
PO Box 1943                                     Road/Footpath Closure & Opening
Hervey Bay Qld 4655

T 1300 79 49 29

F (07) 4197 4455


This application form must be completed and all information be provided to Fraser Coast Regional Council prior
to assessing this application. Failure to provide required information will result in a delay of assessment and
issuing of a permit.

Principal Contractor Business Name and Address:

Principal Contractor Contact Representative:

Postal Address:                                         Phone No:

                                                        Fax No:
Location of Work:

Proposed work to be undertaken:

Traffic Management Plan (signage plan layout): Refer to appendix attached.

Fees and Charges – Failure to provide required fee will
result in a delay of assessment and issuing of a permit.

Road Opening:

Road Opening Permits (includes initial inspection)                $130
Vehicular Crossing (Driveway)
Minor construction on Road Reserves

Inspection Fee (per Visit)                                        $75

Fines for unauthorised works on road                              Monetary Penalties Apply

Road Closure Applications, dedicated public roads
Advertisement of road closures is at full cost to the

                                                                                      Application Form #920551
Closure type:                                             Proposed date of closure:

 Partial Footpath Closure         Partial Road          Proposed commencement:
Advertisement not applicable,     Closure
Notification section to be        Advertisement
completed.                        required,               Proposed completion
                                  Refer to
 Full Footpath Closure           advertisement &
Advertisement not applicable,     notification sections
Notification section to be        below.
                                       Full Road Closure
                                      Refer to
                                      advertisement &
                                      notification sections
Provide copies of Public Liability Insurance:
The holder of a permit. Shall hold or maintain for the whole term of the permit, a
$10,000,000 public risk insurance policy worded to the satisfaction of the Local
Government which names as the insured both the holder of the permit and the Local
Government; and Indemnify the Local Government against and for all damages to or loss
of equipment and/or property and against any claims, suits, actions or demands arising out
of any injury or damage suffered by a person or any injury to property incurred as a result
of the use of roads or land under the control of the Local Government in the form as may
be prescribed by the Local Government from time to time.
Provide details of who will provide traffic control:
If traffic control is to be carried out by the principal contractor, copies of current traffic
controller’s certification and Personal Protective Equipment to be worn must be supplied to
the Local Government.

The permittee shall submit a draft advertisement of the closure to Council detailing;
   • location,
   • type of closure,
   • start and finish date of closure,
   • hours of closure,
   • detour route if applicable

Council will place advertisement in the newspaper and invoice permit holder for associated
advertisement costs. Public advertising of temporary closures must only be advertised by
Fraser Coast Regional Council. Due to newspaper deadlines, advertisement drafts
must be submitted to Council at least seven days prior to publication date.

(Emergency Services, businesses and residents)
Failure to provide evidence will result in a delay in the assessment and issuing of a permit.

   •   Provide copy of letters to local residents and businesses within the affected area
       including the date and extent of the letter drop.

Required for partial or full road closures only:
   • Provide copy of written advice to all emergency services Police, Ambulance, Fire and
      SES of temporary closures and emergency access routes to the site during the
      event. This shall extend to provide written advice to local bus companies. The
      advice shall be provided a minimum of seven days prior to the proposed

                                                                      Application Form #920551
                          Responsibilities on Road Reserve
                   (WHSQ & Council &Dept. Main Roads Requirements)

This summary of Workplace Health and Safety, Council and Main Roads requirements has
been provided for your assistance in establishing your own responsibilities for works in
reserves. As a Principal Contractor or relevant person it is your responsibility to ensure
compliance with all legislation and permits prior to undertaking any works, such as driveway
construction, site access, pipe laying, footpath construction or any other works relevant to
public reserves.
                     (for Principal Contractors and Relevant Persons)

•    WHSQ Regulation requires all work to be carried out according to the WHSQ Traffic
     Management for the Construction or Maintenance Work Code of Practice 2008.
•    A Work Method Statement is also required from the relevant person to provide
     information for controlling risks that exist in the work carried out on or near the
•    When the work on the road reserve coincides with traffic or pedestrians movements,
     reference to the Manual of Uniform Traffic Control Devices is required. This manual
     covers the use and placement of signage and the possible need for Traffic Controllers.
•    A Traffic Management Plan required by the Legal Authority, Dept. Main Roads or the
     Local Authority (Fraser Coast Regional Council, to alter conditions on the roadway, can
     be used as part of the above Safety Plan and Work Method Statement.
•    These documents are to be available on the site where works are taking place, together
     with additional requirements, such as: Site Specific Induction recordings.
•    Site Specific Inductions are to cover and record, general safety information, sighting of
     Blue Cards and Prescribed Occupation Certificate details, for all workers engaged to work
     on the site.
•    Inspectors appointed under WHSQ enforce the above requirements by conducting
     assessments and issuing their enforcement notices.

                    Fraser Coast Regional Council & Dept. Main Roads
                   (for Persons in Control, Principals and Contractors)

•    Main Roads need a Form M994 completed and forwarded to the District Director for
     works for approval, where contracts are entered into.
•    Fraser Coast Regional Council requires an application for a permit to work on their roads
     and reserves. This application must detail the type of work proposed to be undertaken,
     the method of operation and Traffic Management Plan. No works are to commence on
     Council owned land/reserves until a permit from Fraser Coast Regional Council has been
     issued. Thereafter there is a minimum of seven days notification to emergency services
     is required for partial or full road closures. Permits are issued through the External
     Services Directorate.
•    Similar to Main Roads, Fraser Coast Regional Council requires a Traffic Management Plan
     that lays out the placement and types of signage to be erected, and be submitted for
     approval in accordance with the Manual of Uniformed Traffic Devices (MUTCD).
•    Both Fraser Coast Regional Council and Main Roads need a record of signage layout,
     kept daily by site personnel. This is a legal requirement for proceedings resulting from
     an accident.
•    Authorised officers from the Police Service, Fraser Coast Regional Council, Main Roads,
     Workplace Health and Safety and Dept. of Transport can enforce these matters where
     the safe and effective regulation of traffic is lacking or not complying. These officers will
     be using their respective enforcement tools.

     These responsibilities are covered under legislations; the Transport
     Operations (Road Use Management) Act 1995 and the Workplace Health
     and Safety Act 1995.

     Your understanding of the above areas of responsibility is mandatory to
     operate and work safely on roadways including footpaths.

     Please enquire    of   the   three   entities   before   you   commence   your

                                                                          Application Form #920551
Traffic Management Plan (signage plan layout):

Road Name: ________________________________________

Section/Location:                             ____________________________________                                           Local
Sketch or Description:

Show details and sketch or describe the location of the signs/devices (including distances from street or road junction, bridge or
other permanently identifiable point to sign location); or list all the documents that define their details and location.
Reason required:- ______________________________________________________________________________________________

Complete below as applicable for either permanent or temporary installation and/or removal:
□ Permanent Installation and/or Removal
Proposed date of installation and/or Removal: ______________________________
Recommended:                                               / /___            Approved:                                    /
                                                                                       Authorised Officer
Note:- Use to provide approval for erection and/or removal of regulatory signs/ devices including traffic signals, pedestrian
crossings etc. (i.e. those erected to inform motorists of regulations governing movement).
□ Temporary Installation/ Removal by Contractor
Contract Number – _______________________________Contractor – _________________________________
Contractor Nominated Traffic Officer – _______________________________
Traffic Guidance Scheme No: ___________________________
I certify that, as the Nominated Traffic Officer, I have been adequately trained in roadwork’s signing and that the above
changes to regulatory traffic devices are required for the construction of the Works and comply with the Contract and the

           Signed                                     Date               /   /___ (Nominated Traffic Officer of the Contractor)

                                                                                          Application Form #920551
 Instructions for Contractors Traffic Management Plan (signage plan layout):
 1.        This form is to be completed each time the Contractor makes changes to regulatory signs/devices including
      traffic signals, pedestrian crossings etc.
 2.       The location of each sign/device is to be identifiable.
 3.       The form is to be certified by the Nominated Traffic Officer of the Contractor who has the qualifications
      and experience required in the Contract.
 4.       The form is to be submitted with the Traffic Guidance Scheme.
 5.      When the Traffic Guidance Scheme is deemed suitable, a copy will be forward to Fraser Coast Regional
      Council for its records.
 6.       The Contractor is to record and certify the date and time of each traffic switch, the date and time each
      regulatory sign/device is displayed to the public and the measured location, and then the date and time each
      regulatory sign/device is removed.
 7.       The form is to be submitted to Fraser Coast Regional Council when the Traffic Guidance Scheme is
Record Details of Installation and/or Removal of Regulatory Traffic Signs/Devices
Each change to regulatory signs/devices including traffic signals, pedestrian crossings etc is to be recorded in the
table below. Attach additional records if required.

 Sign/Device details            Location                        Date and time it is             Date and time removed
                                (Refer to drawing)              displayed to the public         from public display

                                          Signature: _____________________Date__________                  _________Date____

 Date and Time of Traffic Switches
 Switch   reference              Date                         and        time       of      switch
                          Signature: _________Date____
 Switch         reference                      Date               and                                   time               of
 switch                                    Signature: ___ _____Date____
 Declaration by Person Responsible for Installation and/or Removal
 I certify that the erection and removal of traffic control devices is recorded above. For temporary installation and/or
 removal, I also certify that the traffic control devices have been in place for the full period and, if not, a full report is

                                     Signature: ___________________________Date__________

                                                                                              Application Form #920551

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