Apply for materials to make pothole repairs

Section 1
The personal data you provide on this form will be held by Devon County Council and used for the purpose of administering your bid for Highway Maintenance Community Enhancement Funding. We will keep the data securely for 6 years. Under the General Data Protection Regulations (GDPR) you have the right to ask that your details are deleted if and when your withdraw your bid or for any other reason. More information about how we process your data is available in our  privacy notice

Section 4 - Delivery information
This information is required by our supplier. The material is usually transported by lorry so please take this into account when choosing a delivery location.
Address*
Street Address Address Line 2 Town Post Code
Delivery contact name*
First Last
Delivery contact number*
Is there any information that you feel would be helpful to provide to the supplier regarding the delivery e.g. the best route to the location? Please note that pallet trucks can only be used on firm surfaces (no gravel or soft ground).

Section 5 - Declaration
- I have discussed the work with the Neighbourhood Highway Officer and undertaken any training deemed necessary (this may not apply to the person filling in the form)
- My organisation has joined our Road Warden Scheme
- At least one of the individuals who will be on site has achieved an appropriate traffic management qualification such as a module of Signing, Lighting and Guarding (Chapter 8), and that qualification has not expired
- The potholes my organisation would like to repair do not meet Devon County Council’s intervention criteria intervention criteria
I agree to the conditions above*
- Yes

Section 1