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English (UK)
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Application for a Temporary Road Closure
Town Police Clauses Act 1847: Section 21
Name of applicant
*
First Name
Last Name
Address of applicant
*
Street Address
Street Address Line 2
City/town/village
County
Post code
Daytime phone number
*
-
Area Code
Phone Number
Email address
example@example.com
Date of required closure
*
-
Month
-
Day
Year
Date Picker Icon
Time of required closure
*
Hour Minutes
AM
PM
AM/PM Option
Until
until
Hour Minutes
AM
PM
AM/PM Option
Details/Names of all roads to be closed: (A map of roads to be closed must accompany your application. This is a mandatory field)
*
Upload a map of all roads to be closed
*
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of
Reason for closure request
*
Proposed Diversion Route: (If applicable, a map of roads showing the route diversion must accompany your application)
Please upload a map or maps showing the diversion route (if applicable)
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of
Details of proposed signage and barriers together with locations:(Map of proposed signage and barriers must accompany application)
Please upload a map or maps of the proposed signage and barrier locations
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of
Submit
Should be Empty: