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File #: <br />Date Received: <br />NORTH CAROLINA RAILROAD COMPANY <br />APPLICATION FOR PIPE/ WIRE OCCUPATIONS 14 <br />*APPLICATIONFEE: Waived <br />(".Application Fee of 1200.00 must be made payable to Norfolk Southern Railway Company) <br />The above application fee does not include: (a) special handling fees, (b) engineering review, (c) occupation fees, (d) <br />Railroad protective insurance, (e) estimate preparation, (f) flagmen/watchmen costs/ex enses or <br />incurred by NCRR or the operating railroad. All a p (g) construction costs <br />for the project may be requested, and will be at the sole ecos and expense of L ensee However, a fully executed Lice <br />Agreement and Agreement and Consent Form are requirement prior to the preparation of estimates. nse <br />All applications are to be submitted in accordance with NCR 101 Specification (wire / cable) and/or NCR 102 <br />Specifications (conduits / pipelines). Failure to strictly adhere to these specifications will result in delays, additional <br />costs and possible return of your application. Construction drawings should either be 8 1/2" x 11', 8 1/2" x 14" or 11" x <br />17" size. <br />(Larger size drawings are only acceptable in special circumstances with prior approval of NCRR representative) <br />NO VERBAL approvals will be granted. NO work on NCRR property may proceed until Licensee is in receipt of a <br />fully executed Occupation Agreement and authorization obtained from NCRR and the Operating Railroad. NO PVC <br />pipes. NO Blasting on, under or near NCRR property. NO OPEN CUT installation without prior NCRR approval. NO <br />Directional Boring (NCR 102, Sec.5.1.6.c). NO Facilities within culverts. NO Facilities attached to Railroad Bridges. <br />Name of Licensee: <br />or Orange <br />name to be shown on <br />Agreement) <br />"Note: <br />**Due to future maintenance responsibilities, NCRR will not enter into an occupation agreement with a Developer. <br />Licensee is: O Individual O * Corporation ? Municipality M Other: County Government <br />*State of Incorporation - <br />,icensee's Mailing Address: <br />Count of Orange <br />. Box 8181 <br />lsborou h, NC 27278 <br />aention: Pa-ul -mes, P . E . <br />itle: County Engineer <br />elephone #: ( 919 ) 732-8181 <br />?Send Document to: (If other than Licensee:) <br />Civil Consultants, Inc. <br />3622 Lyckan Parkway <br />suite lonq <br />Durham NC 27707 <br />Attention: Ton M. Whitaker P.E. <br />Title: Consulting Engineer <br />Telephone #: ( 490-164-5-