Isle of Wight Council

	APPLICATION TO REQUEST A TEMPORARY ROAD CLOSURE
	Network Management Date Technician Highways & Transport County Hall Newport Isle of Wight PO30 1UD Phone Number � 01983 823777 Email address � [email protected] Fax number - 01983 823755

Applicant Details

	Title
*	Forename
	Middle name/Initials
*	Surname

*	Building/house name/number
*	Street address
*	Town Name
*	Postcode
	Home Tel Number (include area code)
	Mobile Tel Number
	email address

Site contact details

	Name
	Mobile Tel Number

Location details

	Road name and number
	Exact location (between which two road junctions?)
	Purpose of closure
	Reasons as to why a road closure restriction cannot be avoided

Dates and times

	FROM day and date		Time
	TO day and date		Time

A MINIMUM OF 28 DAYS NOTICE IS REQUIRED BY THE IOW COUNCIL BEFORE A ROAD CLOSURE CAN START FROM THE DATE THE APPLICATION IS APPROVED. THE APPLICANT SHOULD ALLOW TIME FOR THE APPLICATION TO BE APPROVED AND THE START DATE OF THE CLOSURE MAY DEPEND ON OTHER PROGRAMMED WORKS IN THE AREA. IN CASES OF AN EMERGENCY WRITTEN PERMISSION MUST BE OBTAINED FIRST BY EMAILING THE ABOVE ADDRESS.

ROAD CLOSURE CHARGE:

£642.39 INC. VAT

ORDER NUMBER:

....................................................

	DECLARATION
	I HEREBY APPLY FOR PERMISSION TO REQUEST A ROAD CLOSURE ON THE HIGHWAY AND AGREE TO COMPLY WITH THE NECESSARY CONDITIONS REQUIRED BY THE ISLE OF WIGHT COUNCIL. Signature.............................................................. Date.....................................................................

	Data Protection Act 1998
	This application may be monitored by the Isle of Wight Council for regulatory, quality control or crime detection purposes. Information from this application will be processed in accordance with the Data Protection Act 1998 for the purpose of processing your particular enquiry/request. The Isle of Wight Council ("the Council") is the data controller. By completing this form you consent to the Council contacting you by email or nominated contact method in relation to your enquiry/request. The information contained in this application may, in exceptional circumstances, be subject to disclosure to third parties under either the Data Protection Act 1998 or the Freedom of Information Act 2000 to the extent the law allows and in accordance with the Isle of Wight Council's Access to Information Policy. Disclosure will only be made where in all the circumstances it would be fair to do so and in the public interest. Please note that the Council may process your information in the absence of consent for the purpose of crime prevention or detection so far as is in accordance with the law. Sometimes we may use your information to keep you informed about services, goods or relevant issues that we believe may be of interest to you. If you wish to receive this information for these purposes please tick this box To improve the quality of other services that we provide to you the Council wishes to hold your non-sensitive personal information on a secure central database. This will enable all Council services to use this information when they are providing a service to/for you. If you wish your non-sensitive personal information to be held by the Council please tick this box