Traffic Management Plan Extension Form

Applicant Details

Name:	Click here to enter name
Company:	Click here to enter company
Phone number:	Click here to enter phone no.
Email:	Click here to enter email

Request Details

Location:	Click here to enter location
TMP number:	WMK-Click to enter 5 digit TMP no.
Start Date:	Select start date	End Date:	Select end date
TMP End Date: (if applicable)	Select date – for stages being extended with a different TMP end date

Reason for Extension

Click to enter text. ‘date extension’ or ‘extension’ is not a suitable reason.

Conditions

Click to enter text

Note:	Extension acceptance is on the basis that it is relevant to the work being undertaken at the time of the application. Where applicable and unless otherwise stated in the conditions, this extension is applicable to all temporary speed restrictions and road closures within the traffic management plan. 200409043948 This document forms part of the traffic management plan approval and must be on-site and available upon request.

Office Use Only Approved by:

Version 1 - April 2020