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

For NCRR / HNTB use only

123456
WEr123456

PROJECT OWNER/APPLICANT INFORMATION

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123456

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123456
test@test.com
1234567890
1234567890

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Yearly

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Corporation
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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)

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123456
test@text.com
1234567890
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PROJECT INFORMATION

Installation of a new facility
Yes

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Location of Installation:

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284 MP
375 Feet
Longitudinal (parallel to tracks) only – fill in #15 below

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For a transverse crossing under the tracks:

123
123
375 Feet

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For a longitudinal occupancy only:

375 MP
375 Feet
375 MP
375 Feet
375 MP
375 Feet
375 MP
375 Feet

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For a longitudinal and transverse crossing:

375 MP
375 Feet
375 MP
375 Feet
375 Feet
375 Feet
375 Feet

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Electric Power

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Distribution

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Conductors:

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Copper
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DC
440
8
240
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440
440

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12
yes

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no
Direction boring/Horizontal Direction drilling

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Facilities to be installed/utilized Type:

Manholes
10
7
Handholes
10
12
Pullboxes
10
12
Poles (New)
10
12
Poles (Existing)
10
12

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Proposed construction:

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Underground Facilities

375 Feet
345
123
456
456
456
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Bury depth:

375 Feet
375 Feet
375 Feet

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Aerial Facilities

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375 Feet
375 Feet
375 Feet
375 Feet
375 Feet

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Fiber Optic Facilities

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Applicant’s Checklist

Application Package to Include:

  • One (1) copy of completed Wire/Conduit/Cable Occupancy Application (Form NCRR 210)
  • One (1) copy (no larger than half-size, preferably 11”x17”) of the design and construction plans including plan view and profile view of the proposed facility
    • Plans clearly show the extent of proposed work affecting the NCRR Corridor
    • Plans drawn and printed to scale (ensure no unintended scaling occurs during printing)
    • Plans sealed by a Professional Engineer licensed in the State of North Carolina (no crimped seals)
  • One (1) copy of all specifications and computations for the proposed occupancy
    • 3Sealed by a Professional Engineer licensed in the State of North Carolina (no crimped seals)
  • Non-refundable Engineering Review Fee (see Utility Engineering Fee Schedule)
    • 375 Underground Facility Fee Included
  • If any portion of a wireline occupancy is underground, include the following:
    • Soil borings in accordance with Form NCR 102 Section 3.1

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Plan and Profile Submittal Requirements

  • All applicable requirements set forth in Form NCR 101 for all wireline occupancy applications
  • Additionally, all applicable requirements set forth in Form NCR 102 if any portion of the wireline occupancy application is underground

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General Plan View Requirements

  • All existing and proposed railroad tracks shown and labelled
  • North arrow
  • Scale
  • ‘To’ labels for the next town, city or station in either direction along the railroad
  • Name of the town and county in which the proposed facility is located
  • Angle of crossing relative to railroad track(s)
  • Show and label the NCRR Corridor boundary as “NCRR Corridor” and non-operating NCRR property lines as “NCRR Property” (Remove all other Right-of-Way or Property boundaries within the NCRR Corridor)
  • Show dimensions from the NCRR Corridor boundary to the centerline of the NCRR Corridor, centerline of the nearest track and the overall width of the NCRR Corridor
  • If occupancy is within or adjacent to a roadway at-grade crossing:
    • Show roadway edges of pavement, dimension width and roadway name
    • Show edges of pavement with dimensions from edge of road to centerline of proposed/existing poles
    • Show existing warning devices (flashers, gates, etc.) and clearances from devices to proposed wire line / poles
    • Location of all existing and proposed poles and distance from edge of pole to nearest railroad track centerline
    • Nominal voltage of line
    • Note in accordance with NCR 101 Section 1.6.1.C.9 regarding NCRR Specifications

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Additional Plan View Requirements for Aerial Transverse Crossings and Longitudinal Occupancies

  • Dimension distance between poles, from centerline of closest track to wireline, and show assigned pole numbers

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Additional Plan View Requirements for Underground Transverse Crossings

  • Dimension distance from the crossing to any turnouts
  • Location of markers and an example of text on the proposed markers
  • Show launching and receiving pits that are within the NCRR Corridor. Dimension from the pits to the nearest centerline of track. Dimension the length, width and depth of the pits.
  • Details of any excavation or sheeting necessary to install the conduit in accordance with NCR 102 Section 5.9.1.C
    • Length of the conduit on NCRR Corridor
    • Cross section of the wireline showing the conduit, number of innerducts and, wires contained within each innerduct and if any innerducts are empty.
  • Note in accordance with NCR 101 Section 1.6.1.C.9 regarding NCRR Specifications

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Additional Plan View Requirements for Underground Longitudinal Occupancies

  • Location of markers and an example of text on the proposed markers
  • Location of existing above and below ground utilities
  • Note indicating method of installation
  • Size and material of the conduit
  • Length of the conduit on NCRR Corridor
  • Cross section of the wireline showing the conduit, number of innerducts and, wires contained within each innerduct and if any innerducts are empty.

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General Profile View Requirements

  • Scale
  • Draw the profile perpendicular to the track centerline
  • Indicate which direction the section is looking
  • Show number and location of wires, voltage, power, ground and neutral wires, etc.
  • Note in accordance with NCR 101 Section 1.6.1.C.9 regarding NCRR Specifications

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Additional Profile View Requirements for Aerial Transverse Crossings

  • Actual vertical clearance measured from top of high rail for each track to bottom of lowest wire/cable
  • Location of poles and distance from edge of pole to nearest railroad track centerline
  • Dimension span length across tracks from pole to pole
  • Show distance from bottom of sag at 65oF to top of high rail
  • Show pole top configuration and attachment heights of existing and proposed wires

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Additional Profile View Requirements for Aerial Longitudinal Occupancies

  • Show the top of rail profile of the nearest track
  • Elevations
  • Show assigned pole numbers
  • Show pole top configuration or attachment heights for each wireline

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Additional Profile View Requirements for Underground Transverse Crossings

  • Show theoretical embankment lines for all existing and proposed tracks per NCR 102 Section 4.3.1.F.5.
  • Show launching and receiving pits that are within the NCRR Corridor. Dimension from the pits to the nearest centerline of track. Dimension the length, width and depth of the pits.

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Additional Profile View Requirements for Underground Longitudinal Occupancies

  • Show the top of rail profile of the nearest track

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Please Type or Print

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