Name of Licensee (required)
Exact name of owner of utility.
Address of Licensee (required)
Email of Licensee (required)
Phone of Licensee (required)
Fax of Licensee
Number of Tracks to be Crossed (required)
Angle of Crossing To Track (required)
Will This Line Run Parallel To Track (required) YesNo
If so, how far?
Will this crossing be located within a dedicated public street? (required) YesNo
If yes, please indicate the name or number of the street
Do you have the authority to acquire by condemnation? YesNo
If yes, we need a letter from you stating that if you are unsuccessful in getting an agreement for this crossing, you will initiate condemnation proceedings.
Product to be transported
Type of Crossing (required) —Please choose an option—DistributionTransmissionServiceFiber Optics Line
Will a contractor install this crossing? (required) YesNo
If yes, name and address of the contractor:
How many feet and direction from nearest switch, miles post marker, road crossing, or Railroad bridge? (required) —Please choose an option—SwitchMiles Post MarkerRoad CrossingRR Bridge
Select one and indicate number found on structure.
Number found on structure
Section:
Township:
Range:
Other identifying description:
Pipe Specifications
Carrier
Casing
Inside Diameter
Carrier Inside Diameter
Casing Inside Diameter
Mill Pressure CSI
Carrier Mill Pressure CSI
Casing Mill Pressure CSI
Wall Thickness
Carrier Wall Thickness
Casing Wall Thickness
Type of Seam
Carrier Type of Seam
Casing Type of Seam
Laying Lengths
Carrier Laying Lengths
Casing Laying Lengths
Kind of Joints
Carrier Kind of Joints
Casing Kind of Joints
Total Length on Railroad Right-of-Way
Carrier Total Length on Railroad Right-of-Way
Casing Total Length on Railroad Right-of-Way
Method of installing pipe:
Vents:
Size:
Height above ground:
Seals - Both Ends:
Seals - One End:
Base of rail to top of casing:
Cathodic protection YesNo
Protective coating YesNo
Protective coating kind
Type, size and spacing of insulators and supports
Maximum working pressure
PSI Field Test pressure
PSI Type
Location of shut-off valves
Distance from hole to centerline of nearest track
Undertrack crossings to be constructed in accordance with current specifications as designed by the American Railway Engineers Association (AREA).
Aerial Crossing Specifications
Height above top of rail
Poles to be located on property
Voltage
Attach to existing poles? YesNo
If yes, give name and agreement number
You will need to provide a copy of permission to attach to poles belonging to an entity other than yourself.
Aerial crossing to be constructed in accordance with current specifications as designated by the Joint Engineering Committee of the Association of American Railroads (RRA) and the Edison Electric Institute (EEI), and, the specifications of the National Electrical Safety Code (NESC), Part 2, Safety Rules for the Installation and Maintenance of Electric Supply and Communication Lines.
Date you propose to make this crossing:
You will need to provide Cross Sectional and Topographical Drawings at proposed crossing location showing: track, pipe, ditches, slope from property line to property line, vent locations, conduit, depth of pipe or clearance above top of rail, distance from nearest Railroad structure.
By signing this Application, I acknowledge that I have examined and will conform to the specifications as designated by the AREA, AAR, EEI, or NESC, whichever is applicable.
Please Enter Your Name as Signature
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