PIPELINE OCCUPANCY APPLICATION (NCRR FORM 220)

This form is to be used when submitting a utility occupancy application for an underground pipeline. Use NCRR Form 210 for wire, conduit or cable occupancy applications.

Submit a cover letter, including a project description, and the completed application, application fee and one (1) copy of the project plans to:

HNTB North Carolina, P.C.
Attn: Manager, NCRR Pipes and Wires Occupancy Agreement Process
343 E. Six Forks Rd, Suite 200 Raleigh, North Carolina 27609

Plans for proposed installations are to be submitted to, and shall meet the approval of, North Carolina Railroad Company (NCR). Applicant shall enter into an occupancy agreement with NCRR before any construction activities commence on-site. Materials and installation are to be in strict accordance with specifications of the American Railway Engineering and Maintenance-of-Way Association (AREMA), North Carolina Railroad Company, and the Operating Railroads (Norfolk Southern Corporation and/or CSX Transportation as appropriate). The information submitted with this signed application and the required number of copies shall be per the Pipeline and Underground/Aerial Occupancy Application Instructions (NCRR Form 230). The engineering and application fees to be submitted with this application are as stated in the current engineering fee schedule (HN-02).

PROJECT OWNER/APPLICANT INFORMATION

Please provide a valid Owner’s Legal Name.



Name and address of the owner’s engineer or consultant (i.e. the party that will coordinate the project – leave blank if none or same as applicant)

PROJECT INFORMATION

*Please include with the application a copy of the existing agreement between the applicant and North Carolina Railroad and/or Norfolk Southern Railway (or predecessors).



MP
+
Feet

*Use the next lowest whole milepost adjacent to the project location + feet in the direction of increasing milepost to the project location. Applies to all milepost references in this application.

Mainline – Increasing milepost from Greensboro (MP 284) to Charlotte (MP 375)
H-Line – Increasing milepost from Greensboro (MP H-0) to Goldsboro (MP H-130)
EC-Line – Increasing milepost from Goldsboro (MP EC-0) to Morehead City (MP EC-94)


Feet

MP
+
Feet
MP
+
Feet
Feet
Feet

MP
+
Feet
MP
+
Feet
Feet
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Feet











Underground Facilities

Feet
Feet
Feet

Aerial Facilities

Feet
Please provide a valid total aerial length on the NCRR Corridor.
Feet
Feet
Feet

Pipe Data

(psi)
(psi)
Feet

Applicant’s Checklist

The following is a checklist of items that shall be completed when submitting this application for a proposed Wire/Conduit/Cable Occupancy of NCRR Corridor. Please place a check by all items listed below once they are included with the application package. For more detailed descriptions of the requirements below see Form NCR 101 “Specifications for Wire, Conduit and Cable Occupations of North Carolina RailroadCompany Property.”

Application Package to Include:


Plan and Profile Submittal Requirements


General Plan View Requirements


Additional Plan View Requirements for Aerial Transverse Crossings and Longitudinal Occupancies


General Profile View Requirements


Additional Profile View Requirements for Underground Transverse Crossings


Additional Profile View Requirements for Underground Longitudinal Occupancies


If application is approved, applicant agrees to reimburse the North Carolina Railroad Company and the Operating Railroads for any cost incurred by the North Carolina Railroad Company and the Operating Railroads incident to installation, maintenance, and/or supervision necessitated by this pipeline installation, and further agrees to assume all liability for a ccidents or injuries which arise as a result of this installation.