Mobile elevated work platforms (MEWPs) Step 1 of 4 25% Section 1 – applicant detailsName(Required) First Last Company name(Required)Company address(Required) Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÃ…land Islands Phone(Required)Email(Required) Emergency contact details (if different to above). This information will be available to the public.Emergency Contact name First Last Emergency email 24-hour emergency contact number Section 2 – reason for the worksPlease provide details of the reason for the works and why they need to take place on the public highway(Required)Section 3 – locationPlease detail the proposed location/s. Please provide as much detail as possible(Required)Section 4 – Type of Mobile Elevated Work Platform (MEWP)Please provide details as to the type of MEWP being used(Required) Section 5 – When do you propose to do the worksStart date(Required) MM slash DD slash YYYY End date(Required) MM slash DD slash YYYY Start time(Required) Hours : Minutes AM PM AM/PM End time(Required) Hours : Minutes AM PM AM/PM Please provide any additional information in relation to the start and end date and timings in the box below.If your requests relate to multiple locations, please provide as much detail as possible relating to the date and time at each location.Section 6 – traffic managementPlease provide details of the proposed Traffic Management, including provisions for pedestrians. If you are using a Traffic Management company please include their contact details.(Required)Section 7 – additional informationPlease provide any other additional details which may be relevant to the application Section 8 – file uploadPlease upload the location plan, traffic management plan, risk assessment, and evidence of chapter 8 accreditation.Failure to upload the required documents could result in your application being refused and an administration fee incurred. Drop files here or Select files Max. file size: 40 MB. Please tick to confirm the following(Required)All must apply I have attached a location plan I have attached a traffic management plan I have attached a copy of the risk assessment I have public liability insurance that covers the licence period and the activity detailed in this application Suitably qualified personnel will place, operate and maintain the MEWP for the required duration of the licence I have attached evidence of the necessary chapter 8 accreditation (operative and supervisor) or suitable alternatives I have read and agree to the terms and conditions Documentation Failure Section Break Δ