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Permit to work application

Important:
  • You can submit work for one location only per application.
  • This form can must be submitted by the Head Contractor.
  • Apply for your permit to work at least five working days before work begins to allow for your application to be processed.
  • Processing your application may be delayed if your request is submitted with incomplete or inadequate information.
  • An approved Automation Change Request (ACR) is required if your work involves electrical work, automation, SCADA, control systems, calibration or instrumentation. For more information visit Automation change request.
  • An approved Water Shut Off Plan is required if your work involves isolating the water supply network
Council contact information

Tell us who your Council Project Manager or Council contact person is.



Email address will end in @ccc.govt.nz
Contractor information


Tell us who the main contact person is.


This is where we send your updates and permit.







Request details


Tell us what's changing 



Street address or name/number of station, reservoir, etc.





Water supply and wastewater reticulation, wastewater pressure and vacuum tank work only.


Work description

Important:
You can only list one location per application.


Street address or name/number of station, reservoir, etc.




Your combined file size of all attachments must not be larger than 35MB.


Your combined file size of all attachments must not be larger than 35MB.

Your combined file size of all attachments must not be larger than 35MB.

Water supply and wastewater reticulation, wastewater pressure and vacuum tank work only.










Work dates and times






Health and safety

Attachments

Attach any supporting documents related to:

  • Isolations register – Lock out, tag out
  • Safe work methods
  • Site specific safety plans
  • Job safety assessments
  • Site commissioning plans
  • Any attachments associated with high risk work

Your combined file size of all attachments must not be larger than 35MB.