Permit to Dig and Excavation Permit Example
Example document for Permit to Dig and Excavation Permit. Use this as a reference when creating your own.
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Document: Permit to Dig and Excavation Permit
Example Document
Last updated 7/30/2026
PERMIT TO DIG AND EXCAVATION PERMIT
Permit Number: PD-2023-045
1. PROJECT DETAILS
Project Name: Smith Street Warehouse Fitout Site Address: 42 Smith Street, Richmond, VIC 3121 Client Name: Melbourne Logistics Pty Ltd
2. EXCAVATION DETAILS
Description of Work: Excavation for new concrete slab extension and pit for hydraulic lift. Location of Dig: Rear loading dock area, adjacent to existing brick wall. Start Date: 15/11/2023 Expected Finish Date: 16/11/2023
Dimensions:
- Length: 12.0 metres
- Width: 4.0 metres
- Depth: 1.2 metres
Excavation Method: 3 Tonne Mini Excavator with rock breaker attachment.
3. HAZARD IDENTIFICATION AND CONTROLS
Underground Services
Have current Dial Before You Dig (BYDA) plans been obtained? Yes Reference Numbers: BYDA-559923, VICWATER-1123 Have services been located by potholing/hydro vacuum? No (services clear of zone) Controls in place: All services marked in pink spray paint. 'No Dig' zone marked around Telstra pit. Operator to maintain 3m clearance from marked gas main.
Ground Stability
Soil Type: Stiff Clay with some rock Risk of Collapse: Low (under 1.5m) Ground Support Method: N/A (Battering to 45 degrees)
Overhead Hazards
Are there overhead powerlines? No Controls: N/A
Traffic and Public
Is the excavation near a road or public access? Yes (shared driveway) Is a Traffic Management Plan required? Yes Controls: Bollards and witches hats erected across driveway entrance. Delivery trucks diverted to front street. Warning signs displayed.
4. PLANT AND EQUIPMENT
Machinery to be used: Kubota U35 Mini Excavator Operator Name: James Jones Operator Licence Number: 12345678 (Class CN)
5. CERTIFICATION AND SIGN-OFF
I certify that I have inspected the site, reviewed the hazards and controls listed above, and it is safe to proceed with the excavation work.
Excavation Supervisor: ______________________________ Name: Sarah Jenkins Signature: S Jenkins Date: 15/11/2023 Time: 07:00 AM
I acknowledge I have read and understood the controls and conditions of this permit.
Site Manager / PCBU Representative: ______________________________ Name: David Smith Signature: D Smith Date: 15/11/2023
WORK TO STOP IMMEDIATELY IF:
- Unexpected underground services are found
- Ground conditions change or rain causes instability
- Nearby structures show signs of movement
- Unsafe work practices are observed
Notes
Note 1: The permit number PD-2023-045 links this document to the daily site diary. Note 2: The depth is 1.2m. While this is under the 1.5m high-risk threshold for shoring, battering was chosen because the excavation is next to an existing wall. Note 3: The gas main proximity is a critical hazard, hence the specific clearance distance noted in the controls. Note 4: Sign-off occurred at 7 AM before the machinery started.
About this Example
Part of the Permit to Dig and Excavation Permit document collection
Document Type
Permit to Dig and Excavation Permit
A formal document used to authorise and control ground breaking activities to ensure safety and compliance with Australian regulations.