TMP Request Form


Start date*:
Finish date*:
How many full days required*:
Working Days Required*:
Working Times Required*:
NOTE: General AT / RCA rules around working times
Day Works:
Night Works:

Activity / Works

Please note: AT / RCA may request Vehicles Crossing Permits, Building or other Consents before they will give approval.

If you have these please send them through so we can include them in the TMP application.

Site Address / Road Name*:
Activity Description
Vehicles / Equipment Required On Site:
Will there be any excavation during the project?
Are there hazards left in place:
Workspace affects the:
Works will be on:
Do you think a FULL ROAD CLOSURE is required?

Contractor Details

Who is doing the work on site.
Contact Name*:
Contact Number*:
Contact Email*:

Principle Details

Who is work being done for (e.g. Property Owner)
Contact Name*:
Contact Number*:
Contact Email*:

Bill Payer

Who will accept the charges from the Road Controlling Authority for the application?
Bill Payer*:

PO Number

If your accounts team require PO numbers to process invoices - then you MUST provide a PO before we can process the TMP.
PO Number:

Please provide a marked image/screenshot of the work area required.

Please mark up all work areas required particularly if works are on both sides of the road. 
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