Skips within the highway - extension to licence

I have read and agree to comply with the Section B ’Conditions of a Licence for placing a skip within the Highway’ for the placing of a skip on the Highway.

Please tick the following checkbox to agree with the above statement *

Skip license details

I am applying for permission to extend licence number

Address line 1 *

Town or City *

County *

Postcode *

From (date) *

To (date) *

Details of the company who you are applying on behalf of

Company name

Address line 1 *

Town or City *

County *

Postcode *

Contact details

Forname *

Surname *

Address line 1 *

Town or City *

County *

Postcode *

Email address *

Telephone number

By clicking the following checkbox, you agree (on behalf of the company) that the information you have provided is correct *