Application for an Access Protection Marking

Items marked * must be completed

Please ensure that you have read and understood the requirements and conditions for an Access Protection Marking

Your Contact Details

1. Your Name

First Name:*

Last Name:*

2. Address

Find Address: Postcode:

House Name/Number:*

Street:*

Town/City:*

County:*

Post Code:*

Email Address:*

Phone Number:*

Details of your application

3. Are dropped kerbs already provided?* YesNo

4. Is there a garage or drive at the above property?* YesNo

5. Do vehicles regularly park across the entrance to your drive/garage, thereby obstructing your access?* YesNo

6. Is there an establishment such as a school, pub, hotel, shop or church etc. near to your property which is generating an excessive amount of on street parking?* YesNo

if 'Yes', please specify: (maximum 500 characters)

7. Are you a Blue Badge Holder?* YesNo

if 'Yes', please provide Badge Number:

If you are a Blue Badge Holder, we also need you to upload a photocopy of your badge for this application.

No Blue Badge has been uploaded

To upload your document, click on the 'Choose a File' button and select the file you wish to upload.

Files must be in pdf, gif, png, jpg or doc format.

8. Are there any waiting restrictions or parking restrictions outside your house (e.g. single or double yellow lines)?:* YesNo

if 'Yes', please specify: (maximum 500 characters)

Additional Evidence

9. Why do you believe you need an Access Protection Marking?* (maximum 1000 characters)

Declarations

I certify that the information I have submitted is true and accurate.
I have read and understood the requirements and conditions for an Access Protection Marking.
I understand that the fee of £117.00 is non-refundable, regardless of the outcome of my application.
I understand that this fee only covers 1 installation. Should the Access Protection Marking become worn, require renewal or alteration a new application will be necessary and additional payment will be required.

Please tick to indicate that you have read, understood and accept the declarations above.

Please leave this text box blank:

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