Dust Seal Application Form
This form is to apply to have your section of road prioritised against the Council's criteria for semi-permanent seal. Please read the
Date
*
-
Month
-
Day
Year
Date
Applicant's Name
*
First Name
Last Name
Postal Address
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Name of road where section/s are to be dust sealed -
*
Please upload a map or provide a Google Maps screenshot of the location of the section of road
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Do you agree to this application being prioritised against other applications submitted to the Council
*
Yes
No
Do you agree to pay 50% of the cost of construction of a dust seal on the section of road described in this application
Yes
No
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