Reinstatement e-Registration

Reinstatement e-Registration
RNVG
RNDID
DateTime

1- Requestor Details
1.1 Ganger Name *

First NameLast Name
1.2 Telephone Number
1.3 MAP Supervisor Name*
Find the Supervisor Email (Click the Button Below)
Supervisor Email
Supplier's Email*
Please Enter Supplier's Email Address
Partner Name*
Supervisor Name

First NameLast Name

2- Works
2.1 Date & Time
2.2 Permit Reference Number *
2.3 Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
3- Reinstatement Details

Site No- 1
Location Description 1
Local Authority -1
Site Location Area-1

Site No-1 Description

	Description	Point	Easting	Northing	Other details e.g. Broken Flags
Reinstatement Type
Reinstatement State (Permanent/Interim) *
Reinstatement Date *
Length (mm) *
Width (mm) *
Depth (mm) *

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Site No-2
Location Description 2
Local Authority- 2
Site Location Area- 2

Site No-2 Description

	Description	Point	Easting	Northing	Other details e.g. Broken Flags
Reinstatement Type
Reinstatement State (Permanent/Interim) *
Reinstatement Date *
Length (mm) *
Width (mm) *
Depth (mm) *

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Site No- 3
Location Description 3
Local Authority- 3
Site Location Area- 3

Site No-3 Description

	Description	Point	Easting	Northing	Other details e.g. Broken Flags
Reinstatement Type
Reinstatement State *
Reinstatement Date *
Length (mm) *
Width (mm) *
Depth (mm) *

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Site No- 4
Location Description 4
Local Authority- 4
Site Location Area- 4

Site No-4 Description

	Description	Point	Easting	Northing	Other details e.g. Broken Flags
Reinstatement Type
Reinstatement State *
Reinstatement Date *
Length (mm) *
Width (mm) *
Depth (mm) *

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Site No- 5
Location Description 5
Local Authority- 5
Site Location Area- 5

Site No-5 Description

	Description	Point	Easting	Northing	Other details e.g. Broken Flags
Reinstatement Type
Reinstatement State *
Reinstatement Date *
Length (mm) *
Width (mm) *
Depth (mm) *

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Site No- 6
Location Description 6
Local Authority- 6
Site Location Area- 6

Site No-6 Description

	Description	Point	Easting	Northing	Other details e.g. Broken Flags
Reinstatement Type
Reinstatement State (Permanent/Interim )
Reinstatement Date *
Length (mm) *
Width (mm) *
Depth (mm) *

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