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R/W (161A) : Party of the Second Part certifies that this agreement is true and accurate copy of the form <br />R/W (161A) incorporating all revisions to date. <br />IN WITNESS WHEREOF, each of the parties to this agreement has caused the same to be executed the day and <br />year first above written. <br />DEPARTMENT OF TRANSPORTATION <br />BY: <br />DIVISION ENGINEER <br />ATTEST OR WITNESS: <br />Second Party <br />INSTRUCTIONS <br />When the applicant is a corporation or a municipality, this agreement must have the corporate seal and <br />be attested by the corporation secretary or by the empowered city official, unless a waiver of corporate <br />seal and attestation by the secretary or by the empowered City official is on file in the Raleigh office of the <br />State Utilities Manager. In the space provided in this agreement for execution, the name of the <br />corporation or municipality shall be typed above the name, and title of all persons signing the agreement <br />should be typed directly below their signature. <br />When the applicant is not a corporation, then his signature must be witnessed by one person. The <br />address should be included in this agreement and the names of all persons signing the agreement <br />should be typed directly below their signature. <br />This agreement must be accompanied, in the form of an attachment, by plans or drawings showing the <br />following applicable information: <br />1.All roadways and ramps. <br />2.Right of way lines and where applicable, the control of access lines. <br />3.Location of the proposed encroachment. <br />4.Length and type of encroachment. <br />5.Location by highway survey station number. If station number cannot be obtained, location <br />should be shown by distance from some identifiable point, such as a bridge, road, <br />intersection, etc. (To assist in preparation of the encroachment plan, the Department’s <br />roadway plans may be seen at the various Highway Division Offices, or at the Raleigh <br />office.) <br />6.Drainage structures or bridges if affected by encroachment. <br />7.Typical section indicating the pavement design and width, and the slopes, widths and <br />details for either a curb and gutter or a shoulder and ditch section, whichever is applicable. <br />8.Horizontal alignment indicating general curve data, where applicable. <br />9.Vertical alignment indicated by percent grade, P.I. station and vertical curve length, where <br />applicable. <br />10.Amount of material to be removed and/or placed on NCDOT right of way, if applicable. <br />11.Cross-sections of all grading operations, indicating slope ratio and reference by station <br />where applicable. <br />12.All pertinent drainage structures proposed. Include all hydraulic data, pipe sizes, structure <br />details and other related information. <br />13.Erosion and sediment control. <br />14.Any special provisions or specifications as to the performance of the work or the method of <br />construction that may be required by the Department must be shown on a separate sheet <br />attached to encroachment agreement provided that such information cannot be shown on <br />plans or drawings. <br />15.The Department’s Division Engineer should be given notice by the applicant prior to actual <br />starting of installation included in this agreement. <br />16.Method of handling traffic during construction where applicable. <br />17.Scale of plans, north arrow, etc. <br />300 W. Tryon St, Hillsborough, NC 27278 <br />Laura Jensen <br />Orange County, North Carolina <br />Travis Myren (County Manager) <br />Docusign Envelope ID: 760CDFBB-CB5A-8248-801C-F8109CF51094