Event Manage

Your Name*:

Your Email*:

Event Start Date*:

Event Name*:

Applicant Information

Company/Applicant Name (responsible for the filming)*:

Does the company name match the name insured on the Public Liability Insurance*:

Yes

Contact Details

Your Position/Title*:

Your Mobile*:

Is the on-site contact on day of filming same as above*:

Yes

No (please fill in contact details below)

Name:

Position/Title:

Phone:

Email:

Production Information

Project Name*:

Production Type*:

Feature Film

TV One-Off or Series

Short Film

Student Film

TVC

Live Stream

Sporting event

Other

If other - please specify:

Proposed Filming Dates*:

Alternative filming dates (weather hold/contingency planning)*:

Filming times (including bump-in and bump-out times)*:

Location Information

Exact location/s of the proposed filming? (Including any privately owned land)*:

Please provide a brief summary or synopsis of the scene and/or activities

Number of people on location

Number of cast*:

Number of crew*:

Number of parking spaces required at the filming location

Number of cars*:

Number of trucks*:

Number of oversize vehicles (over 7.5m long or over 4.5 tonnes)*:

Unit Base

Will the production need a unit base?*:

Yes

Exact location/s of the proposed unit base? (including any privately owned land):

Unit base times (start/finish):

How many car park spaces required at unit base?:

Number of cars:

Number of trucks:

Structures

Will the production erect any temporary structures such as tents or marquees at the unit base?:

Yes

If YES: Please provide details of these temporary structures (size, number style):

(Please note: temporary structures need to be secured by weights, not pegs or stakes)

Traffic Management

Will the production require traffic management or pedestrian management?:

(Please note: If the production is disrupting traffic or pedestrian flow a Traffic Management Plan (TMP) or Pedestrian Management Plan (PMP) Incorporating a Risk Management Plan will be required).

Yes

Type of activity (e.g. hold & release, road closure):

Name and details of the traffic/safety company who will be supplying the TMP or PMP:

What times will the roads be affected:

Name of the roads affected by the closure/traffic hold:

Details of any large equipment the production will bring to the location:

(E.g. camera cranes, scaffolding, lighting towers.)

Please select if the production will involve any of the following:

firearms/weapons (including imitation)*

amplified music or sound

other safety concerns*

stunts*

may have environmental impact

may cause offense or concern to the public

Provide details of activity:

Will the proposed filming represent the actual location?:

Yes

If NO: Please identify the location the filming will represent::

AttachmentsPlease upload the relevant documentation for your production. If the documentation is unavailable
to be sent at this time please indicate via email the date on which it will be sent.

Public liability insurance: Proof of certificate of currency* :

Please note: A permit will not be issued without current PLI

Parking application :

For parking cars, trucks, oversized and other essential vehicles.
Please find form at https://www.strathbogie.vic.gov.au/images/Assets/2019-2020_Consent_for_Works_in_the_Road_Reserve.pdf

Site plan/mud maps: :

Identifies Parking, Traffic control, unit base, where crew are situated and any equipment other than
the normal amount of filming equipment required for the shoot e.g cranes, long dolly, boom lifts,
scissor lifts.

Running Sheet/Schedule * :

A document which establishes a chronology, linking times, events and details of filming activities.

Stakeholder communication plan (Public notification letter)* :

The purpose of this is to give traders, residents and other interested parties timely written notice in
advance of your proposed filming activities and show how you’ll address their concerns.

Traffic & Pedestrian management plan(s) :

Required if traffic will be slowed, blocked, redirected, or perhaps even distracted. Be certain to
check if you need permits from Victoria Police and VicRoads (attach your copies of their permits in
the ‘Other permits, approvals etc’ section at the end of this form).

Risk management plan or safety plan :

Complete this if a risk management plan isn’t already attached to a traffic management or
pedestrian management plan, or other activities involve risk you need to manage, e.g. trip hazards,
explosives.

Other permits, approvals or filming information (running sheets, schedules) :

Any other permits or approvals we have asked you for. For example Victoria Police, VicRoads, Parks
Victoria, a waste management plan, etc.

Victorian Screen Industry Code of Conduct :

Signature* :

Clear

By signing this you agree that all details are correct and you agree to abide by the Victorian Screen Industry Code of Conduct

Filming Permit Application Form (Strathbogie Shire Council)