DESIGN - CLIENT REQUEST

Company*

Are you an existing or new client?*

ExistingNew

Person submitting request*

First NameLast Name

Email of person submitting*

enter your email here to get a copy of this submission

Mobile Number*

Please enter a valid phone number.

Is there an alternate contact to communicate with for this request?*

YESNO

Alternate Client Contact for Permit

First NameLast Name

Alternate Contact Email

If second contact available/required

Alternate Phone Number

If second contact available/required

Location/State of Work Site:*

South East QldNorth QldNew South WalesOther

Request Type*

New Design Pack RequestPermit RenewalUnsure - TQ to provide adviceOther

Request Type*

Did you want us to commence design immediatelyDiscussion requiredOther

If renewal, enter current Road Authority Permit number here *

Request Contact for Scoping*

Brisbane DepotTownsville DepotGrafton DepotUnsure - Request TQN to contact

Type of works being carried out*

If excavation, how deep?*

This information is essential for the permit submission

Closure Type required*

Purchase Order if required

If a PO is required for TQN to get paid and it is not entered here, additional admin charges may apply

Work Order if required

If a WO is required for TQN to get paid and it is not entered here, additional admin charges may apply

Which Council region is works located *

Average wait times shown above

If "Other" is selected

Location of Works*

Additional Location Details (if required)

Side Street

City/SuburbState

Other location info

Extra location info if required

Road Authorities resonsible for issuing permit approvals have varied processing times. Please contact our office for an indication of timeframes.

Please understand that we have no control over these timeframes.

Expected start date of work (there is no guarantee for these dates on permits approval)

Date

Hour Minutes

Expected end date of work for permit (There is no guarantee for these dates on permits approval)

Date

Hour Minutes

Preferred Hours of work*

Alternate Preferred hours of work (if applicable)

Comments (if required)

Are any of the following in the workzone*

Choose multiple if applicable

How close to the trafficable lane will workers on foot be working?*

Do you have the Traffic Counts?*

YESNO

Traffic count data

Traffic Count File Upload

List of plant required in work zone (and size of plant if its larger than standard vehicle & plant)

If plant or vehicle in work zone is larger than a standard utility or van then this information is essential to the TGS and permit application.

After Hours Care: 1) Will the site be returned to its original condition at the completion of shifts/jobs? NOTE: This may require additional TGS's*

YESNOOther

After Hours Care: 2) Will plant/equipment be left on-site at end of a shift? NOTE: This may require additional TGS's*

YESNOOther

Site access & exit: (will Traffic Control need to Hold/Release for construction movements?)*

YESNOOther

Will Footpath or Verge be used for Work Area?*

YESNOOther

If you replied yes to any of the above 3 questions please add details here

File Upload

If the file is too large to be uploaded here, please email it separately to design.team@trafficqld.com.au

Extra details if required

Is an extension required? i.e. works are longer than 30 days*

YESNOUNSUREOther

I understand and agree to the following:*

	Agree
Permit Application fees are not refundable and once an application has commenced, you will be liable for the costs incurred regardless of any changes in circumstances, disprovals or delays.
Whilst great care is taken to ensure accuracy when scoping works, there will be occasions where more documents are required than initially expected. You will be liable for the payment of these items as required.
Any estimates or quotes provided are a guide only. If the legislated requirements to complete the design or works exceed the estimate, you will remain liable for the payment of these items.
By placing an order for traffic control or ancillary services with the Company, after receiving the Schedule of Rates and Terms of Business, it is acknowledged that a properly authorised representative of the client, acting on their behalf, has thoroughly read, comprehended & confirmed the order.
By confirming the above, this confirmation signifies the establishment of a legally binding agreement between the client & the Company for the acquisition of the services at the specified rates & under the stated terms.

Click HERE to view Terms of Business

Click HERE to view the Shedule of Rates Terms & Conditions

Signature*

DESIGN - CLIENT REQUEST

Please use one request form per project or location only