North Carolina railroad company

NORTH CAROLINA
RAILROAD
COMPANY

PIPELINE OCCUPANCY APPLICATION
(NCRR FORM 220)

This form is used submitting a utility occupancy application for an underground pipline Use NCCR Form 210 for wire, conduit or cable occupancy applications.

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

HNTB North Carolina, P.C
Attn Manger NCCR Pipes and Wires
Occupancy Agreement process
343 E.Six Rd,Suite 200
Raleigh, North carolina 27609

For NCCR/HNTB use only

Plans for proposed instalLations are to be submitted to,and shall meet the approval of,North Carolina Railroad comapny (NCR).Applicant shall enter into an occupancy aggremnt with NCRR before any construction activites commence on-site.Matrials and installation are to be in strict accordance with specifications of the american Railway Engineering and maintence-of-way Association(AREMA), Nort carolina railroad comapny,and opertaing railroads(norfolk southern coroporation and /or CSK Transportation as appropriate) The information submitted with signed application and requred number of copies shall be the per pipeline and undergrouned/Areial occupancy Applications istructions(NCCR form 230).The engineering and application fees to be submitted with this application stated in the current engineering fee schedule(HN-02).

PROJECT OWNER/APPLICATION INFORMATION

*Please ensure that the exact legal name is provided with no abbreviations.

6.Billing: Owners prefers

7.Owner is a

Name and Adress of owner's engineer or consultant(i.e the party that will cooridante the project-leave bank if none or same appliacnt)

PROJECT INFORMATION

10.Proposed work involves (check all that apply)
Exiisting Agrrement for installation?

Please include with the application copy of the existing agreement between applicant and north Carolina Railroad and/or Norfolk southern Railway(or Predecesores).

11.Location of installation

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

Mainline-increasing milepost from Greensboro (MP 284) to Charlotte (MP 375)

H-Line-increasing milepost from Greensboro (MP H-0) to Goldsbro (MP H-130)

EC-Line-increasing milepost from Goldboro (MP EC-0) to Morehead (MP EC-94)

13. Orientation of proposed pipeline installation :

14.For a transverse crossing under the tracks

15.For a Longitudinal occupency only:

16.For a longitudel and transverse crossing :