where applicable) Number of personnel on site: Other contractors on site: Are keys Required? Yes No If so, which keys: Part 3 Permit Requirements – Are works occurring within 12m of live traffic Electrical Permit lane? (If yes, then a Entry into confined Dial Before You Dig Yes No Yes No Yes No (LV/HV) required for Yes No Traffic Management space required? Required? works? Plan is to be submitted) Part 4 Plant and Equipment – Plant / Equipment to be brought on site Materials to be brought on site: Applicants sign-off
where applicable) Number of personnel on site: Other contractors on site: Are keys Required? Yes No If so, which keys: Part 3 – Permit Requirements Are works occurring within 12m of live traffic lane? (If yes, then a Traffic Management Plan is to be submitted) Yes No Entry into confined space required? Yes No Dial Before You Dig Required? Yes No Electrical Permit (LV/HV) required for works? Yes No Part 4 – Plant and Equipment Plant / Equipment to be brought on site Materials to be brought on site: Applicants sign-off
PNLK_SF_120A_%20Contractor_Control_Lease_Boundary_Access_Request.docx