I/We acknowledge that all information provided above is true and accurate. If my application is successful I will be responsible for all
costs, including sign design, manufacture, installation and maintenance. I am aware that the sign(s) within the state-controlled road
reserve can be removed at my expense where it may impact on future road works or installation of public liability services, changes in
the nature of traffic or the alignment of the road or at the expiry of the approved permit.