1Page 1 2Page 2 3Page 3 4Page 4 5Page 5 6Page 6 7Summary Progress Contractor details Business and contact details for the contractor undertaking the work Confirmation I confirm I am the contractor undertaking the work and take responsibility for the excavation. I confirm I have approval from utilities for connections to services You must confirm all of the above in order to proceed. Please do not continue with this application as it cannot be submitted unless you have confirmation of the above. Company name Business address To enter an address outside the Liverpool boundary, use the 'enter address manually' option below. Postcode Find Address Loading addresses... Select Address -- Please select -- Address line 1 Address line 2 (optional) City Postcode Clear postcode/address Use the Lookup Postcode button to find the address.If you cannot find the address, please enter it manually First name Last name Email address Contact number Public liability insurance Upload evidence of valid Public liability insurance This must not be less than £5 million and valid for the full period for which the licence is issued. It can be a scanned copy or photograph but must clearly show business details, amount of cover and start/expiry dates. Emergency contact Name Emergency 24-hour contact number No information is required, please proceed to the next page. Supervisor details Name of supervisor Upload evidence of supervisor Street Works Qualification Register (SWQR) card Enter the supervisor Street Works Qualification Register card number Operative details Name of operative Upload evidence of operative Street Works Qualification Register (SWQR) card Enter operative Street Works Qualification Register card number No information is required, please proceed to the next page. Details of the works Is the licence for major or minor works? Major works include new gas service, new water service or other new apparatus, services or connections. Minor works involve alterations or repairs to existing services. Major works Minor works Major works description -- Please Select -- New gas supply New water supply New electrical supply New telecoms connection Other Minor works description -- Please Select -- Repair existing gas supply Repair existing water supply Repair existing electrical supply Repair existing telecoms connection New kerb Other Please describe the works Expected start date Start time hh:mm (24 hour clock) Expected completion date End time hh:mm (24 hour clock) Which road features are involved? Verge Footway Carriage way No information is required, please proceed to the next page. Location of works Address Postcode Find Address Loading addresses... Select Address -- Please select -- Address line 1 Address line 2 (optional) City Postcode Clear postcode/address Use the Lookup Postcode button to find the address.If you cannot find the address, please enter it manually Location description This should be property number (not business name) or distance in metres from the nearest junction. If your works are at a single point, please give the Easting and Northing coordinates. If your works are not at a single point, please give the Easting and Northing coordinates of the first point and end point on line of work. Coordinates for Easting should only be between 333096 and 345612, Northing between 381357 and 397973. Are works at a single point Yes No Easting coordinates Northing coordinates Easting coordinates of first point on line of work Easting coordinates of end point on line of work Northing coordinates of first point on line of work Northing coordinates on end point on line of work No information is required, please proceed to the next page. Traffic control arrangements Which form of traffic control do you intend to use? Contraflow Footway closure Pedestrian crossing Diversion route plans Lane closure Bus lane Cycle lane No carriageway incursion None applied Road closure Parking/loading bays Traffic control (convoy working) Traffic control (give and take) Traffic control (multi-way signal) Traffic control (priority working) Traffic control (stop/go boards) Traffic control (two-way signals) Upload Traffic management plan No information is required, please proceed to the next page. Declaration Agreement and declaration by contractor By submitting this form I agree to comply with the relevant highways act and licence conditions. I will pay the applicable fees associated with this licence application. I have provided the required details and drawings requested for this licence and understand it will usually take 7 to 14 days' notice to process this application, with an exception to this occasionally made in an emergency. Failure to comply with the relevant highways act and licence conditions will result in withdrawal of your licence, a fine or prosecution. You must agree to the above declaration in order to submit this application. No information is required, please proceed to the next page. Before you submit this form please review your answers below. If you need to change anything, use the 'previous' button on the bottom left to go back to a section. Then submit the form by selecting the 'Submit button' at the bottom of this page Loading form summary...